Assistant Educator (if applicable)
I have agreed to submit this application by electronic means. By signing this application electronically, I certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge, including information provided about the citizenship or alien status for each household member applying for benefits.I also certify that:
NEW INTAKE COORDINATOR ACKNOWLEDGEMENT OF ANTI-HAZING POLICY AND HOLD HARMLESS AGREEMENT
The undersigned, as the New Intake Coordinator in Psi Sigma Phi, Multicultural Fraternity, Incorporated. (herein after referred to as “the Organization”), acknowledges that "I" understand and agree to the following:
GENERAL DEFINITION OF HAZING
“Any action taken or situation created, intentionally, whether on or off fraternity premises, to produce mental or physical discomfort, embarrassment, harassment, or ridicule. Such activities may include but are not limited to the following: use of alcohol; paddling in any form; creation of excessive fatigue; physical and psychological shocks; quests, treasure hunts, scavenger hunts, wearing of public apparel which is conspicuous and not normally in good taste; engaging in public stunts and buffoonery; ethically degrading or shameful games and activities; and any other behavior which are not consistent with fraternal law, ritual or policy or the regulations and policies of the educational institution.”
PART I – DECLARATION OF PURPOSE
A) The purpose of this Agreement is to contractually state and declare Psi Sigma Phi’s commitment to its constitutional Anti-Hazing Policy and its intent to obtain every assurance possible to prevent acts of hazing from occurring.
B) The organization will take every measure to hold every member accountable for any acts of hazing in which he allows prospective member(s) to become involved alone or in the company of others who are members or claimed members and knowingly protects those who engage in acts of hazing. For purpose of knowledge in this content we mean anyone who knows or should have known.
C) No applicant for membership in the organization is required to subject himself to any form of hazing; the Prospective Member is specifically prohibited from tolerating or going along with any improper conduct during his Membership Intake Process in the form of hazing; and the Prospective Member is expected and requested to immediately contact a local, regional or national representative of the Fraternity by telephone, fax, e-mail or regular mail and notify him of said conduct. The contact information for the National Headquarters is as follows:
PART II – ACKNOWLEDGEMENT OF ANTI-HAZING POLICY
The statements in this Section are to expressly acknowledge each Prospective Members’ understanding of the organization’s Anti-Hazing and Anti-Pledging Policy as follows:
“Psi Sigma Phi Multicultural Fraternity, Incorporated. shall not permit its members to engage in any form of physical or mental brutality against any prospective new member/interest, or any other fraternity member. Any person found in violation of this clause shall be under review by the Executive Board and/or Judiciary Board of Psi Sigma Phi Multicultural Fraternity, Inc. All proper school officials as well as the Dean of Students shall be notified.” Such activities and situations include, but are not limited to:paddling in any form; creation of excessive fatigue; physical and psychological shocks; quests, treasure hunts, scavenger hunts, wearing publicly apparel which is conspicuous and not normally in good taste; engaging in any public stunts and buffoonery; morally degrading or humiliating games and activities; late work sessions which interfere with scholastic activity; and any other activities which are not consistent with Fraternal Law, Ritual, or Policy or with Regulations and Policies of the educational institution. Hazing is forbidden by the organization’s Constitution and by public laws of the various states.”
I have read the Fraternity’s Definition of Hazing, Declaration of Purpose and Acknowledgement of Anti-Hazing Policy above and agree to observe its prohibitions and comply with its contents as Intake Coordinator.
PART III – ACCEPTANCE OF INTAKE RESPONSIBILITY
The undersigned Intake Coordinator(s) understands that his involvement in any Membership Intake Education is in accordance to the organization’s constitutional/by-laws as aforementioned in this agreement. Any action outside or in violation of this agreement is understood thereafter as “acting” in his own volition and strictly voluntary in nature. Participation in the process as Intake Coordinator of the organization does not and will not absolve the Intake Coordinator of any responsibilities and liabilities deemed outside or in violation of this contract. Therefore, the undersigned Intake Coordinator(s) understands that Psi Sigma Phi Multicultural Fraternity, Incorporated. does not condone such activities or behavior defined as hazing and his failure to adhere to any of the organization’s and institutional anti-hazing policies or/and inform any such activity against his/their prospective(s) or that occurs in his presence, during the course of any assembly or come across with a member(s) of the Organization or during his/their Membership Intake Process, will result in appropriate disciplinary action against the Intake Coordinator(s), including , but not limited to penal and legal actions.
I have read this section on Acceptance of Responsibility and agree to accept responsibility for my own actions and conduct in connection with the Membership Intake Process and assume liability, were I to allow myself to subject or/and allow acts established to be Hazing, including injuries and damages, and any legal fees which the Organization has to pay arising from my actions or inaction as Intake Coordinator.
SECTION IV – INDEMNITY AND HOLD-HARMLESS CLAUSE
The undersigned Intake Coordinator(s) agrees that where he allows his Intake Class to be subjected to prohibited action or unlawful demeanor or other activity measured to be hazing, resulting in mental harm or physical injury, including death, he agrees to defend, indemnify and hold harmless Psi Sigma Phi Multicultural Fraternity, Incorporated and all of its Regional, State and Local Body, Entity, Organization, Chapter, Advisor, Officer or Member thereof, for any claim of injury and/or damages arising there from, including legal fees incurred to the organization.
SECTION V – SEVERABILITY
In the event that any section of this Agreement is rendered void as against civic Policy or as against the laws of any particular jurisdiction, it is agreed that the remaining clauses of this Agreement, will remain in full power and result.
SECTION VI – AFFIRMATION
The undersigned Intake Coordinator affirms that he has read this document, which includes the Psi Sigma Phi Multicultural Fraternity, Incorporated Anti-Hazing and Anti-Pledging Policy, and taken the Phimen Privilage Program, & Intake Coordinator Training Program and that he fully understands the contents thereof, and verifies that he has not in any way, form or fashion been coerced, forced or made any promises to sign this document and that he has signed the same of his own accord and of his own free will.
I, the undersigned Intake Coordinator for of Psi Sigma Phi Multicultural Fraternity Incorporated, am fully aware that I am holding accountability for this Intake Education Process and all Information decimated during the process. I also hold myself accountable for any violation against the organization’s constitution and risk management policies as per the organization’s constitution Article XIII, & Article XIV. I am also a member in good standing as per the organization’s constitution Article III, Section II.