Alpha Gamma Xi Sorority, Incorporated Membership Registration

Alpha Gamma Xi Sorority, Incorporated
ALPHA GAMMA XI SORORITY, INC. 2024 APPLICATION FOR MEMBERSHIP

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Required Documents List

Application submitted without the required documents will be considered incomplete and will be rejected.
1. Completed Application for Membership
2. Proof of Military Service/Privileged Service
  - APPROVED DOCUMENTS LIST
    
    DD Form 214 and/or separation order
    
    LCPO and/or DIVO
    
    Current PCS Orders
    
    LES Statement
    
    Military Discharge Certificate
  - Copies of any documents submitted WILL NOT be returned. (Conceal SSN/Benefits Number prior to submitting)
3. Letters of Recommendation (3)
  - From supervisor and/or Commander
  - From community service leader
  - From personal reference
4. Photocopy of picture ID (Conceal unique ID numbers prior to submitting)
5. Illustrate concisely, in one (1) page or less, how you will dedicate yourself to the Alpha Gamma Xi Sorority, Inc. mission to provide programs and initiatives to women of the armed forces so they can assist in accomplishing the vision of service, sisterhood, stewardship, scholarship, and solidarity.
6. Signature on Anti-Hazing, Agreement to Arbitration & Privacy Policy

AGXi APPLICATION PROCESS
- Submit the Application for Membership via email with all required documents.
- By completing and submitting a membership application, you have hereby agreed to and will be held accountable by the AGXi Agreement to Arbitration, Anti-Hazing policy, Disaffiliation Form when required, Non-Disclosure Statement, and AGXi Policies.
- Allow 5-7 business days to verify our receipt of your application (The National Director of Membership will notify applicants of receipt of the application).
- Once the application deadline is reached, the National Membership Committee will review your application and qualifications for candidacy in the Intake Program.
- If approved for the Diamond Intake Process the total fee is $375 and will be invoiced as follows:
  - Upon invitation in the Diamond Intake Process, $187.50 must be submitted within 72 hours as Intake Process slots are limited.
  - Upon successful completion of the Diamond Intake Process and a formal invitation has been received from the Director of Membership the remaining $187.50 must be submitted within 24 hours.
**All fees are non-refundable**
email: membership@alphagammaxi.org

Name*

First NameMiddle NameLast NameSuffix
Phone Number*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
List organizational affiliations (Greek or Service related):
Date of Birth*

MonthDayYear
Date
List positions held, if any/When:

MILITARY AFFILIATION

Proof of military service and/or affiliation is required and must accompany application submission. Refer to website www.alphagammaxi.org for approved documents list
Branch of Service:*

ACTIVE DUTY (AD)HONORARY / PRIVILEGEDROTC ( 2 years served)RETIREDRESERVE/GUARDVETERAN
Time in Service: * years * months
AD - Are there any current/pending disciplinary actions against you?*

YesNo
If yes, explain:
VETERAN/RETIREDdischarge type:*

CIVILIAN EMPLOYMENT INFORMATION

(Applicants without an Active Duty Classification)
Employer:
How long?
Position
Phone Number
Please enter a valid phone number.
Email
example@example.com
Street Address Line 2

CityState / Province

Postal / Zip Code
Any current/pending disciplinary actions against you?

YesNo
If yes, explain:

EMERGENCY CONTACT
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship:*

REFERENCES

(Letters of Recommendation from the following categories MUST accompany application) Current SUPERVISOR and/or COMMANDER, COMMUNITY SERVICE LEADER & PERSONAL REFERENCE

	FULL NAME	CATEGORY	PHONE	EMAIL
REFERENCE
REFERENCE
REFERENCE

COMMUNITY INVOLVEMENT

	Title of Activity/Program	Supervising Staff Name	Contact#	Start Date:	End Date:	Brief Description of Duties
COMMUNITY REFERENCE
COMMUNITY REFERENCE
COMMUNITY REFERENCE
COMMUNITY REFERENCE

REFERRALS BY AGXI MEMBER(S)

	Member Full Name	Colony/Chapter:
Referrals
Referrals

GENERAL INFORMATION

Have you ever been convicted of either of the following under the name on this application or under any other name?
Felony (any crime punishable by more than one year in prison)*

YesNo
Misdemeanor (Less serious offenses that typically result in such punishments as a heavy fine and/or a jail sentence not exceeding a year)

YesNo

What interests you about Sorority ?*

Upload Your Photo and Related Documents

Cancelof

Authorization/Compliance Information*

I certify that all of the above information is true and accurate. I authorize the verification of the information provided on this form as to my military service, employment, community involvement, and my overall character and dependability, as it pertains to my application for membership. If my application is approved, I shall conform to the membership practices of the organization. I understand that any fees paid to National Headquarters are non-refundable. By signing this application. I agree to not disclose any information about my diamond intake process, or the procedures/policies of AGXi. I cannot use any part of this form for personal gain or the advancement of any other organization formed or to be formed. I understand that falsifying or withholding information on this application is prohibited and such actions shall deem my application rejected and I may be permanently banned from membership in Alpha Gamma Xi Sorority, Incorporated.
"If you are missing one or more of these items above, you are not eligible to register."
Name

First NameLast Name
Signature*

Clear
Date Signed*

MonthDayYear
Date

AGREEMENT TO ARBITRATION
Authorization/Compliance Information
I First Name Last Name affirm that I understand and agree that any grievances and all disputes brought by prospective members resulting from claims for personal injury, claims for damages to property, or disputes of any nature that cannot be resolved within the Sorority, including those arising from the membership intake process, will be referred to arbitration. Any grievances and disputes regarding membership intake should be referred to the National Membership Director for investigation and resolution. The prospective member specifically agrees to follow all the rules, regulations, and guidelines relating to
the intake process. The prospective member further agrees to report in writing any infractions and violations of the rules, regulations, and guidelines relating to the intake process. The prospective member acknowledges that Alpha Gamma Xi Sorority, Incorporated is an international organization with entities located throughout the United States of America and abroad. By submitting this membership application, the prospective member recognizes that she agrees to the foregoing matters. The prospective member understands that this Agreement affects interstate commerce and is subject to the Federal Arbitration Act. The prospective candidate, her heirs, and assigns, and Alpha Gamma Xi Sorority, Incorporated, its officers, employees, agents, affiliates, chapters, colonies, and members, agree that any disputes, conflicts, claims, and/or causes of action of any kind whatsoever, including but not limited to contract claims, personal injury claims, bodily injury claims, injury to character claims, and property damage claims arising out of or relating in any manner whatsoever to membership of Alpha Gamma Xi Sorority, Incorporated or the membership intake process shall be subject to and resolved by compulsory and binding arbitration under the Federal Arbitration Act, 9 U.S.C. Section 1, et seq., and the commercial rules of the American Arbitration Association.

Type your full name here as a binding agreement of this application. REQUIRED
If printing and submitting via fax or mail, the applicant MUST sign.
Name

First NameLast Name
Signature

Clear
Date

MonthDayYear
Date

ANTI-HAZING POLICY
Authorization/Compliance Information
It is the policy of Alpha Gamma Xi Sorority that hazing in any form is illegal. Any member and/or Candidate participating in hazing is subject to disciplinary action. “Hazing is defined as any action taken or situation created by any Alpha Gamma Xi, Chapter or member to produce or result in mental or physical discomfort, embarrassment or ridicule or as may otherwise be prohibited by local rules, statutes, or ordinances. Some of the prohibited behaviors may include but are not limited to paddling or physical abuse in any form; creation of fatigue including sleep deprivation; physical or psychological shocks; kidnapping; scavenger hunts; personal servitude; lineups; the use of Pledge requirements such as signatures or interviews as a means of harassment; any activities which may tend to expose initiates or pledges to physical danger including but not limited to activities involving the consumption of any alcoholic beverage or any other beverage; any other activities which would disrupt public order or tend to bring the Sorority into disrepute in the local community and any other activities not consistent with Alpha Gamma Xi Sorority principles; federal, state, provincial or local laws, whether voluntary or involuntary.” It is further the policy of the Sorority that initiation activities for membership in the Sorority are designed for the sole purpose of creating harmony and sisterhood among the persons so involved and instructing them in the principles of the Sorority found in its Constitution, history, and traditions. Under the authority given by the Constitution and the Executive Board, we hereby make the following pronouncements relating to the Sorority’s policy: Any subject individual to sanctions according to these rules is entitled to all procedural due process protections provided herein.

Type your full name here as a binding agreement of this application. REQUIRED
If printing and submitting via fax or mail, the applicant MUST sign.
Name

First NameLast Name
Signature

Clear
Date

MonthDayYear
Date

PRIVACY POLICY
Your privacy is very important to us. Accordingly, we have developed this Policy for you to understand how we collect, use, communicate disclose, and make use of personal information. The following outlines our privacy policy. • Before or at the time of collecting personal information, we will identify the purposes for which information is being collected. • We will collect and use personal information solely to fulfill those purposes specified by us and for other compatible purposes unless we obtain the consent of the individual concerned or as required by law. • We will only retain personal information as long as necessary for the fulfillment of those purposes. • We will collect personal information by lawful and fair means and, where appropriate, with the knowledge or consent of the individual concerned. • Personal data should be relevant to the purposes for which it is to be used, and, to the extent necessary for those purposes, should be accurate, complete, and up-to-date. • We will protect personal information by reasonable security safeguards against loss or theft, as well as unauthorized access, disclosure, copying, use, or modification. • We will make readily available to applicants information about our policies and practices relating to the management of personal information. We are committed to conducting our business per these principles to ensure that the confidentiality of personal information is protected and maintained.

Type your full name here as a binding agreement of this application. REQUIRED
If printing and submitting via fax or mail, the applicant MUST sign.
Name

First NameLast Name
Signature

Clear
Date

MonthDayYear
Date

Should be Empty:

Alpha Gamma Xi Sorority, Incorporated

ALPHA GAMMA XI SORORITY, INC. 2024 APPLICATION FOR MEMBERSHIP

Required Documents List

AGXi APPLICATION PROCESS

MILITARY AFFILIATION

CIVILIAN EMPLOYMENT INFORMATION

EMERGENCY CONTACT

REFERENCES

COMMUNITY INVOLVEMENT

REFERRALS BY AGXI MEMBER(S)

GENERAL INFORMATION

AGREEMENT TO ARBITRATION

ANTI-HAZING POLICY

PRIVACY POLICY