Thiel College - Greek - Fraternity Recruitment Form

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FRATERNITY RECRUITMENT FORM

Instructions:

Please fill-out this form completely.
When completed, press the Submit button at the bottom of the page.

First Name

Last Name

Middle Name

Preferred First Name

On-Campus Phone

Cell Phone Number

Year at Thiel during the 2013-14 academic year:

- -

Medical Conditions

Is there any documented disability which you would like the groups to be aware of? If so, please describe.

Legacy Information

Are you related to someone who has been a member of a fraternity? Yes No

If you answered yes, please check the following that may apply:

Grandfather(s) -

Name(s) (please include name, fraternity name, and college or university)

Father(s) -

Name(s) (please include name, fraternity name, and college or university)

Brother(s) - (please include name, fraternity name, and college or university)

Have you ever been a member of a national fraternity? Yes No

If you answered yes, please provide the name and location of the fraternity and when you were a member.

Fall 2012 Academic Schedule

Monday

Tuesday

Wednesday

Thursday

Friday

I hereby verify that the above information is correct to the best of my knowledge. Furthermore, I offer this document as a waiver permitting the release of my grade-point average and other student information to the Director of Greek Life.

Signature

Verification Information
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