Complete and return all forms to:
$50.00 to be submitted with completed application
Zeta Phi Beta Sorority, Inc.
Archonette Club c/o Phi Kappa Zeta Chapter
P.O. Box 63691 Woodbridge, VA 22195
OS
Zeta Phi Beta Sorority, Inc.
Phi Kappa Zeta Chapter
Woodbridge, VA
Complete and return all forms to:
$50.00 to be submitted with completed application
Zeta Phi Beta Sorority, Inc.
Archonette Club c/o Phi Kappa Zeta Chapter
P.O. Box 63691 Woodbridge, VA 22195
About Zeta Phi Beta Sorority, Inc. and the Phi
Kappa Zeta Chapter
Zeta Phi Beta Sorority Inc. was founded January 16,1920 on the campus of
Howard University in Washington, D.C. Five coeds, Arizona Cleaver, Pearl Neal,
Myrtle Tyler, Viola Tyler and Fannie Pettie were encouraged by Charles Robert
Taylor and A. Langston Taylor, members of Phi Beta Sigma Fraternity, Inc. to form
a sister organization. The sorority's principles are Scholarship, Sisterly Love,
Service and "Finer Womanhood."
Phi Kappa Zeta Chapter (PKZ) was chartered on December 5, 2007 in Woodbridge,
VA by eight women ranging in all professional backgrounds and age groups. PKZ
programming primarily focuses on education/literacy, meeting the needs of
women and children, and health/wellness.
The Archonette Club
The Phi Kappa Zeta Archonette Club charted in 2008. In 2008 four young ladies
were the first to become Archonetts in Prince William County. These High School
aged young ladies demonstrated an interest in the goals and ideals of Scholarship,
Sisterly love and community service. In addition to an opportunity to join the
Archonette Club the program encourages young ladies to become future
members of Zeta Phi Beta Sorority, Inc.
Eligibility for the Archonette Club
Applicants must meet the following Eligibility Requirements: Residency in Prince
William County; High school student ages 14-18; Minimum GPA of 3.0 (on a 4.0
scale)
Zeta Phi Beta Sorority, Incorporated
Chapter
INFORMED CONSENT & A RELEASE OF LIABILITY
(To be completed by each Participant and a Member of Zeta Phi Beta, Sorority, Incorporated)
I hereby release and hold harmless Zeta Phi Beta Sorority, Incorporated,
Chapter, its agents, representatives, and employees (collectively and individually Zeta
Phi Beta Sorority, Incorporated) from any and all liability which may arise in connection with my
participation in any and all activities sponsored by Zeta Phi Beta Sorority, Incorporated, or any other
offices, departments, or organizations associated with Zeta Phi Beta Sorority, Incorporated. Such
activities so sponsored shall be referred to as Programs.
This release shall include, but shall not be limited to potential liability from accidents or injuries which
may occur in connection with or potential liability from the content of any and all Programs.
Furthermore, I agree to indemnify Zeta Phi Beta Sorority, Incorporated,
Chapter from any suit, claim or any other action brought by any parent, whether biological, adoptive or
custodial, guardian or family member of any youth participating in any Program on account of or in
connection with my participation in any and all Programs.
I understand that Zeta Phi Beta Sorority, Incorporated, is not responsible for determining whether the
content of any Program is suitable for the participants but that such determination shall be made by the
participant. I declare that I have read completely the terms of this Release and that I understand fully and
voluntarily accept each and every term of this Release.
Name of Parent or Guardian (Please Print):
Signature of Parent or Guardian:
Date:
Participant's Name:
Home Address:
Emergency Contact Name (Please Print):
Emergency Contact Phone Number:
Allergies:
Advisor's Signature:
Event/Activity:
16
I Zeta Phi Beta Sorority, Inc.—National Youth Affiliates Advisors' Manual
Building on the Principles ofZeta and Blazing New Paths
I grant Zeta Phi Beta Sorority, Inc. the unlimited right to use and/or reproduce photographs or
likenesses in any legal manner for the internal or external promotional and information activities of
Zeta Phi Beta Sorority, Inc. I also agree to allow my child to be interviewed and/or photographed by
representatives of the external news media in relation to any and all coverage of Zeta Phi Beta
Sorority, Inc in which he/she is involved. I also agree to allow my child's work and/or photograph to
be published on the Zeta Phi Beta Sorority, Inc. national and local chapter Web site/Internet pages,
and publications. I further understand that by signing this release, I waive any and all present or
future compensation rights to the use of the above stated material(s).
Name of Parent or Guardian (Please Print):
Signature of Parent or Guardian:
17
The Archonette Member's Handbook — Fifth Edition
Youth Club Membership Application
Date submitted
Date approved
Name
Date of Birth
Address
City/State
Zip
Telephone Number_
Cell number
.Age
Email
Name of School Attending
Religious Preference
Grade Level
Hobbies/Special Interests
Mother's/Father's/Guardian Name
Number
Address (if different).
My child,
Zip.
has my permission to become an active member of the
Youth Group of Zeta Phi Beta Sorority, Inc.
Parent/Guardian Signature
Date
Emergency Contact Information: Contact Person
Relationship
Number
Please list any known medical problems
Hobbies
Archonette candidates should include a one-page essay stating why they should be
considered for membership into the Archonettes of Zeta Phi Beta Sorority, Inc.