Award Request
If requesting the Silver, Golden and/or Platinum Certificates, you can list the brothers names in the comments section. The same applies if you are requesting Service Order Certificates. Otherwise, please one request form per brother.
Submitter's Info
Your Name
*
First Name
Last Name
Your Position in Kappa Psi
Your Email
*
example@example.com
Your Phone Number
Format: (000) 000-0000.
Recipient's Info
Recipient's Name
*
First Name
Last Name
Is the Recipient a Brother?
Yes
No
Chapter
*
School
*
Award(s) to be Bestowed
*
F. Harvey Smith: Grand Regent's Letter of Recognition
W. Bruce Phillips: Certificate of Commendation
Service Order Certificate
Robert A Magarian: Order of the Silver Mortar for 25 years of membership
F. Harvey Smith: Order of the Ruby Mortar for 40 years of membership
Preston W. Eldridge Jr.: Order of the Golden Mortar for 50 years of membership
Dewey D. Garner: Order of the Diamond Mortar for 60 years of membership
Norman A. Campbell: Order of the Platinum Mortar for 70 years of membership
Date to be Printed on Certificate
*
-
Month
-
Day
Year
Date
Why is this recipient deserving of the specified award(s)? - 1 paragraph
*
Suggested Length: One paragraph
Mailing Info
Where is the award going?
Date you would like the reward received
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Would you like to submit another entry?
Yes
No
Save
Submit
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