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Affiliation Agreement & Grade Release Form
Name (First and Last)
Include the capital T and all zeroes ex: T00123456
Date you first entered UA Little Rock
ex: August 2016
Choose your affiliated chapter.
(CPC) Gamma Zeta Chapter of Chi Omega Sorority
(CPC) Eta Sigma Chapter of Kappa Delta Sorority
(IFC) Little Rock Chapter of Delta Chi Fraternity
(IFC) Theta Eta Chapter of Kappa Sigma Fraternity
(IFC) Zeta Eta Chapter of Pi Kappa Alpha Fraternity
(NPHC) Epsilon Phi Chapter Alpha Kappa Alpha Sorority, Inc.
(NPHC) Kappa Psi Chapter of Alpha Phi Alpha Fraternity, Inc.
(NPHC) Mu Kappa Chapter of Delta Sigma Theta Sorority, Inc.
(NPHC) Kappa Alpha Psi Fraternity, Inc.
(NPHC) Alpha Beta Eta Chapter of Phi Beta Sigma Fraternity, Inc.
(NPHC) Thee Pi Kappa Chapter of Omega Psi Phi Fraternity, Inc.
(NPHC) Xi Theta Chapter of Zeta Phi Beta Sorority, Inc.
I agree to the Affiliation Agreement and Grade Release Form.
I hereby acknowledge the acceptance of an invitation to membership from the University of Arkansas at Little Rock Greek Life System. I understand that I must adhere to policies of the University and the Interfraternity, National Panhellenic, and the National Pan-Hellenic Councils as they relate to my membership.
I agree to the Anti-Hazing Statement.
I have been informed of the University's policies against hazing. I understand that these practices are harmful and illegal, but also have no place in Greek-letter organizations. I will not allow myself to be hazed, nor will I tolerate the harassment of any fellow members. If my individual efforts to eliminate hazing do not work, I promise to notify the proper authorities (Dean of Students/Greek Advisor) of the hazing activities to which I am aware.
This field is for validation purposes and should be left unchanged.
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