Q.1
Name *


Q.2
Address *





Q.3
Phone Number *


Q.4
E-mail Address *

Q.5
For verification, please give us your birthdate. *



Q.6
At which chapter are you applying for the position of High Pi? *

Q.7
At what chapter were you initiated and what is your Zeta number? *

Q.8
Where are you currently employed? *

Q.9
What is your occupation? *

Q.10
Did you hold any Fraternity offices during your time as an Undergrad?

Q.11
First Institution Attended *

Q.12
Years Attended *

Q.13
Degree *

Q.14
Second Institution Attended?

Q.15
Years Attended

Q.16
Degree Earned

Q.17
Third Institution Attended

Q.18
Years Attended

Q.19
Degree Earned

Q.20
Statement of Intent by High Pi Applicant *

*Note: This statement may be used for public relations initiatives by the General Fraternity. All information disclosed here is doing so with that knowledge.

Q.21
Affirmation by the Proposed High Pi: By filling out this form and checking the box below, I give my electronic signature to the preceding statements and I agree to faithfully adhere to the oaths and obligations associated with the office of High Pi. I affirm that I have read and meet the standards set forth in Code 3-7 of Statutory Code. I understand that I will not be paid for my services as High Pi and that by accepting payment for any services to the Fraternity I will automatically disqualify myself from holding office as High Pi. I will report to the Grand High Pi any violation of the laws or policies of the Fraternity within the Chapter. I will attend the majority of Chapter meetings, I will furnish such reports as may be requested of me by the Grand High Zeta or the Office of Administration, and I agree to serve as Chairman of the Chapter’s Alumni Advisory Board as provided in Code III-8a. I understand that the Grand High Zeta may terminate my appointment at any time. *

Q.22
By typing your name in the box below, you are affixing you digital signature to this document. In doing so you are stating that all the information provided above is accurate *