NPHC Intake Declaration Form Frostburg State University
1. This form must be submitted to the Office of Greek Life immediately after the
interviews/selection of aspirants (potential new members) and twenty-four hours prior to
the start date of the official process/education of aspirants. Chapters should verify that
public documents of the fraternity/sorority intake procedure be on file at the office in 209 Lane
University Center. This form will be kept confidential and will be shared only with university
officials.
2. YOU MUST INCLUDE a COPY of the Official letter on letterhead stating your chapter has
been cleared for intake. Documentation of your Membership Intake Program must include at
minimum:
a) Scholarship Program
b) Community service opportunities, leadership development, campus involvement
c) Fraternity/Sorority History
d) Calendar of all intake and chapter events, including dates and locations especially if they
involve travel and a detailed description of all new member activities
e) The national anti-hazing statement, signed by all members and new members
f) Other pertinent information regarding your new member education program
g) It is suggested that chapters provide all dates to each new member containing all
information regarding the new member education program.
h) Was this program devised by your: ( ) (Inter) National Office and/or ( ) Regional Chapter ( )
Local Chapter
3. Please complete the form with names of the candidates for membership intake and
authorized national representative who has authority to approve the intake program that
states your intake window/cluster timeline. All off location events must be documented
and preapproved by the university. Only candidates that are enrolled at Frostburg State
University during the semester in which intake is scheduled to occur are eligible for intake and
membership initiation.
4. Additionally, each candidate must sign the Grade Release Form and complete a NonHazing Form which can be completed in the Greek Life Office prior to the start date of the
official process/education of aspirants.
5. At the conclusion of the intake process (after initiation) the chapter President or delegate
must submit an updated chapter roster included member names and student ID numbers to the
Greek Life office.
Fraternity/Sorority: ____________________________________________________
Chapter Officer in Charge of Intake: _______________________________________
Signature: _________________________________
Position: ___________________________
Phone: _________________
Email: _______________________________________
The Graduate Chapter Officer and/or the National Officer who approved intake:
(Membership Intake Program as outlined above must be attached to this form)
Name: ____________________________________
Signature: _________________________________
Email: ____________________________________
Phone: _________________
Times, Dates, and Locations of Informational Sessions: ______________________
Date for Selection: _____________________
Start Date of Official Process/Education: _______________________
Date for Initiation: ________________________
Date for Probate: _________________________
Grade Release Form
The Family Education Rights and Privacy Acts of 1974 prohibit the release of personally
identifiable information from the students’ education records without their prior written
authorization. Exceptions to this policy are limited to:
1) release of such information to a specific list of officials with a legitimate educational interest in
the record;
2) the release of such information in response to a court order, health or safety emergency, or
approved research project; or
3) the release of public directory information which has not been previously restricted by the
student.
I have an interest in accepting membership in the organization mentioned above and hereby
consent to the release of the following information to the indicated offices:
Records to be disclosed: Semester grade point average and cumulative grade point average
and any other records as authorized to the Office of Fraternity and Sorority Life.
Parties to whom the records Chapter President, Chapter and/or Faculty Advisors,
Scholarship may be disclosed: Chairperson, National Headquarters Staff, Chapter Executive
Officers, and the Office of Fraternity and Sorority Life.
Purpose of disclosure: For use in university affiliation authorization, chapter scholarship
statistics, educational programming, awards recognition, and verification of minimum academic
standards and requirements.
Length of disclosure: This authorization shall remain in effect as long as I remain a member of
the organization and I am enrolled at Frostburg State University, unless I submit a written
revocation of this authorization to the Office of Greek Life.
By signing this form, I agree to the Grade Release Policy.
Candidate’s Name
Signature
___________________________________
Chapter President (Signature)
Student ID #
Cum
GPA
Sem
GPA
__________________________
Date
___________________________________
Assistant Director of Student Activities for Greek Life
__________________________
Date