Lifetime Membership Form

Instruction: This completed form and appropriate fee must be submitted to the International Office by a member of the Fellowship to become financially active with the International Office. A late fee is assessed when the payment is paid after October 31st of the current fiscal year. The Fellowship’s fiscal year begins on September 1st and concludes on August 31st. All payments must be made by money order, check, or charge card (i.e., MasterCard or VISA only). Do not mail cash. Members may also submit payments at the International Web Site via Pay Pal. Dues payments are NOT tax deductible. Please also note that affiliate chapters may impose individual dues payments which are independent of International Office dues payments.

Indemnity Against Liability Provision:

As a member of Groove Phi Groove Social Fellowship, Inc., I do hereby acknowledge that International policy prohibits all forms of hazing or any other act which may otherwise result in physical bodily harm to any individual engaged in a membership initiation program, and do hereby agree at all times to abide by this International prohibition, and further agree to hold Groove Phi Groove Social Fellowship, Inc. and/or any of its affiliated chapters harmless against any liability whatsoever for any physical and/or mental injury that may be caused by or attributed to my conduct, behavior or actions (i.e., participation) in the initiation of any individual inducted (or trying to become inducted) into the Fellowship.

All installment payments toward the Installment Plan are to be paid between September 1st and December 31st to count for the specific fiscal year

Lifetime Membership Fee Structure

Life Time Member Installment Plan for Fellowmen with 20 or more years seniority.

The Lifetime Membership Installment Option allows you to obtain a Lifetime Membership by paying the fee in annual installments instead of all at once. This makes the Lifetime Membership fee easier to budget.

Fellowmen with 20 or more years seniority can participate in the installment program with payment of an application fee of $150 plus an initial installment payment of $500. Following an initial payment of $650, you agree to pay $500 annually for two consecutive billing

cycles. After the initial payment, you will have 2 remaining payments which

must be paid by December 31st each subsequent year. The member may pay off the balance any time before the contract expiration date without penalty.

Open enrollment for the plan begins on September 1st and ends on December 31st each year. Upon approval by the International Office, the member will receive email notification of acceptance. Each member enrolled in the Lifetime Installment Plan will be recognized as an annual member until the balance is paid in full. Payments may be made by the mailing of a check or online by credit card.

Lifetime privileges and a Lifetime Membership card will be issued when the Lifetime Membership fees have been paid in full. Once you are a Lifetime Member, you will never pay dues again, however, you will be required to pay an annual $100 support fee.

Delinquencies will be handled as follows:

· Member will receive a 30-day warning if payment not received by Jan 15th.

· Installment agreement goes into default on February 15th if installment payment has not been received.

· There are no refunds if the installment plan goes into default, any outstanding funds will be applied to a one year or three-year membership, whichever is applicable.

The price for membership is $650.00 now and then $500.00 per year for 2 more Years (total $1,650.00).