Psi Rho Phi Membership Interest Application

PSI RHO PHI Military Fraternity, Incorporated®

Membership Interest Application
Membership Application Submission Instructions

Please complete the Membership Application and upload all required documents below.

File Naming Format:
FirstName_LastName_DocumentType
(Example: John_Doe_Service_Verification_Letter)

Only submit your Application Fee and complete your Background Check at this stage.

If you experience issues uploading documents, email:
pledges@psirhophimilfraternity.org

**ALL FEES ARE NON-REFUNDABLE**
PERSONAL INFORMATION:
Name

First NameMiddle InitialLast Name
DOB:

MonthDayYear
Date
Email Address:
example@example.com
Permanent Address:
Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone (area code):
Format: (000) 000-0000.
MILITARY AFFILIATION:
Upload Military Verification Document (Required)

(VA Service Benefit Letter, Military Orders, or Military ID—ID numbers may be redacted)
Cancelof
Veteran Branch of Service:
Time In Service Years:
Month:
Type Discharge:
EMPLOYMENT INFORMATION: (Applicants without an Active-Duty Classification)
Employer:
How long?
Phone:
Format: (000) 000-0000.
E-mail:
example@example.com
Location

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position:
Any current/pending disciplinary actions against you?
If yes, explain:
Were you referred by a PRP MEMBER? If yes provide the member's name:
- POLICY ACKNOWLEDGEMENT
  
  Anti-Hazing Policy:
  Psi Rho Phi Military Fraternity, Incorporated strictly prohibits hazing in any form. This includes physical, mental, verbal, financial, or coercive activities associated with membership intake. All candidates are expected to uphold and support a zero-tolerance policy against hazing.
  
  Privacy Statement:
  Candidates agree to maintain confidentiality of all fraternity-related information, including but not limited to membership processes, internal operations, communications, and proprietary materials. Unauthorized disclosure may result in disciplinary action and/or legal consequences.
  
  Agreement to Arbitration:
  By applying for membership, candidates agree that any disputes related to the intake process will be handled internally and, if necessary, resolved through binding arbitration in accordance with applicable laws and fraternity procedures.
- I certify that I have read and understand the Anti-Hazing Policy, Privacy Statement, and Agreement to Arbitration as outlined above.
  
  I acknowledge my responsibility to comply with all Psi Rho Phi Military Fraternity, Incorporated policies and guidelines.
  
  I understand that any violation, falsification, or misconduct may result in disqualification or removal from the membership process.
- I understand that falsification of any information on this application or attachments will eliminate me from being considered for membership into Psi Rho Phi Military Fraternity, Incorporated. By signing this form, I verify that all the information I have provided is true and correct. I understand that at any time, Psi Rho Phi Military Fraternity, Incorporated can rescind any rights or privileges to an applicant based on the submission of false information or documents.
- Application Fee: $40
  
  Submit your payment using one of the methods below:
  
  Zelle (Preferred – No Fee):
  psirhophi7@gmail.com
  Amount: $40.00
  
  Cash App:
  $PsiRhoPhiMilFrat
  Amount: $41.10 (includes 2.75% processing fee)
  
  Note: Applicants must send the full amount to ensure the $40 application fee is received.
  
  ALL FEES ARE NON-REFUNDABLE
- Signature of Candidate:
- Date:
  
  MonthDayYear
  Date
- ©2026 PSI RHO PHI MILITARY FRATERNITY INC.: All rights reserved. For internal use only. Confidential and Proprietary
Should be Empty:

PSI RHO PHI Military Fraternity, Incorporated®

PERSONAL INFORMATION:

EMPLOYMENT INFORMATION: (Applicants without an Active-Duty Classification)