New Member Application
Before You Begin This Application Please Be Sure That You Have The Following Ready:

Email address *
To Do List
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First & Last Name *
Contact Number *
Email *
Date of Birth *
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Name of University/College *
Current Residence *
Required
Home Address *
Emergency Contact
Emergency Contact = EC || Parent or Guardian
EC Name *
EC Phone # *
EC EMail *
New Member Demographic
African, Black Native American Asian, including Indian subcontinent and Pacific Islands Hispanic, Latino Caucasian, White Middle Eastern - Other
Nationality *
Nationality || Ethnic Group
Do You Have Any Family Members That Are Greek?
(List Below)
Greek Family Members
Employment Information
Please Provide Employer Name, Address, Manager Contact Info
Currently Employed
Academic Profile
Graduation Year *
What is your Major(s)? *
What is your Minor(s)? *
Semester/Class Standing? *
What is your GPA? *
Social Media Account Disclosure
Do You Have a Social Media Account/s? Please List All Social Media Accounts and User IDs and/or URLs
List Social Account *
Fraternal References
How did you hear about Psi Sigma Phi? (Current Brother, Female Acquaintance, Friend, Another Student)
References *
Extra Curricular Activities
Are You Currently Involved in Any Extra Curricular Activities and/or Professional Organizations? Please List All Extra Curricular Activities and/or Professional Organizations and Position Held.
Extra Activities
Short Essay
In addition to the Personal Essay potential new members are required to submit a 250-500 word essay on the following topic: How did you learn about Psi Sigma Phi Multicultural Fraternity and what made you even more intrigued to become a member? - Please copy and paste Short Essay Below
Short Essay *
Personal Essay
In addition to the Short Essay potential new members are required to submit a 250-500 word essay on one of the following topics below:

Evaluate a significant experience, achievement, risk you have taken, or ethical dilemma you have faced and it impact to you.

Discuss some issue of personal, local, national, or international concern and its importance to you.

Describe a character in fiction, a historical figure, or a creative work (as in art, music, or science, etc.) that has had an influence on you and explain that influence.

What impact will joining Phi Sigma Phi Multicultural Fraternity have on you, your family, and your community?

A range of academic interests, personal perspectives, and life experience adds much to the educational mix. Given your personal background, describe an experience that illustrates how you would bring awareness to your college/university of the importance of Multiculturalism, or an encounter that made you realize the importance of Multiculturalism.

Topic of your choice.

Personal Essay *
New Member Application Acknowledgement of Anti-Hazing Policy and Hold Harmless Agreement
Fraternity Anti-Hazing Policy/Anti-Pledging Policy

No chapter of Psi Sigma Phi Multicultural Fraternity, Incorporated shall indulge in any physical abuse or undignified treatment (hazing) of its members or prospective members. Hazing is defined as: any action taken or situation created intentionally or unintentionally, whether on or off Fraternity premises, to produce mental or physical discomfort, embarrassment, harassment, or ridicule.

Such activities and situations include, but are not limited to:

*Paddling in any form
*Creation of excessive fatigue
*Wearing publicly apparel which is conspicuous and not normally in good taste
*Engaging in any public stunts and buffoonery
*Morally degrading or humiliating games and activities
*Any other activities which are not consistent with Fraternal Law, Ritual, or Policy or with Regulations and Policies of the educational institution
*Physical and psychological shocks
*Quests
*Treasure hunts
*Scavenger hunts
*Late intake sessions (past 12 midnight) which interfere with scholastic activity
*Hazing is forbidden by the Organization's Constitution and by public laws of the various states.

PROSPECTIVE MEMBER ACKNOWLEDGEMENT OF ANTI-HAZING POLICY AND HOLD HARMLESS AGREEMENT

The undersigned, a candidate for membership in Psi Sigma Phi, Multicultural Fraternity, Incorporated. (herein after referred to as “the Organization”), acknowledges that he understands and agrees as follows:

GENERAL DEFINITION OF HAZING

“Any action taken or situation created, intentionally, whether on or off fraternity premises, to produce mental or physical discomfort, embarrassment, harassment, or ridicule. Such activities may include but are not limited to the following: use of alcohol; paddling in any form; creation of excessive fatigue; physical and psychological shocks; quests, treasure hunts, scavenger hunts, wearing of public apparel which is conspicuous and not normally in good taste; engaging in public stunts and buffoonery; ethically degrading or shameful games and activities; and any other behavior which are not consistent with fraternal law, ritual or policy or the regulations and policies of the educational institution.”

SECTION I – DECLARATION OF PURPOSE

A) The purpose of this Agreement is to contractually state and declare Psi Sigma Phi’s commitment to its constitutional Anti-Hazing Policy and its intent to obtain every assurance possible to prevent acts of hazing from occurring.

B) The organization will take every measure to hold a member accountable for any acts of hazing in which he allows himself to become involved alone or in the company of others who are members or claimed members and knowingly protects those who engage in acts of hazing. For purpose of knowledge in this content we mean anyone who knows or should have known.

C) No applicant for membership in the organization is required to subject himself to any form of hazing; the Prospective Member is specifically prohibited from tolerating or going along with any improper conduct during his Membership Intake Process in the form of hazing; and the Prospective Member is expected and requested to immediately contact a local, regional or national representative of the Fraternity by telephone, fax, e-mail or regular mail and notify him of said conduct. The contact information for the National Headquarters is as follows:

Psi Sigma Phi Multicultural Fraternity Inc.

330 Changebridge Road
Pine Brook, NJ 07058

SECTION II – ACKNOWLEDGEMENT OF ANTI-HAZING POLICY

The statements in this Section are to expressly acknowledge each Prospective Members’ understanding of the Fraternity’s Anti-Hazing and Anti-Pledging Policy as follows:

“Psi Sigma Phi Multicultural Fraternity, Incorporated. shall not permit its members to engage in any form of physical or mental brutality against any prospective new member/interest, or any other fraternity member. Any person found in violation of this clause shall be under review by the Executive Board and/or Judiciary Board of Psi Sigma Phi Multicultural Fraternity, Inc. All proper school officials as well as the Dean of Students shall be notified.” Such activities and situations include, but are not limited to: paddling in any form; creation of excessive fatigue; physical and psychological shocks; quests, treasure hunts, scavenger hunts, wearing publicly apparel which is conspicuous and not normally in good taste; engaging in any public stunts and buffoonery; morally degrading or humiliating games and activities; late work sessions (past 12 Midnight) which interfere with scholastic activity; and any other activities which are not consistent with Fraternal Law, Ritual, or Policy or with Regulations and Policies of the educational institution. Hazing is forbidden by the Fraternity’s Constitution and by public laws of the various states.”

SECTION III – ACCEPTANCE OF RESPONSIBILITY

The undersigned Prospective Member understands that his involvement in any Membership Intake Process is of his own volition and strictly voluntary in nature. Participation in the process as a stated Member of the organization does not and will not absolve the Member of any responsibilities and liabilities imposed by law and of duties owed by one human being to another to hold inviolate personal, human and civil rights and not engage in conduct injurious to the physical and mental well-being of another. Therefore, the undersigned Prospective Member understands that Psi Sigma Phi Multicultural Fraternity, Incorporated. does not condone such activities or behavior defined as hazing and his failure to inform any such activity against his person or that occurs in his presence, during the course of any assembly or come across with a member of the Organization or during his Membership Intake Process, will result in appropriate disciplinary action against the Prospective Member, including , but not limited to dismissal of the Prospective Member from consideration for membership in the organization and the forfeiture of all fees paid to date.

SECTION IV – INDEMNITY AND HOLD-HARMLESS CLAUSE

The undersigned Prospective Member agrees that where he allows himself to be subjected to prohibited action or unlawful demeanor or other activity measured to be hazing, resulting in mental harm or physical injury, including death, he agrees to defend, indemnify and hold harmless Psi Sigma Phi Multicultural Fraternity, Incorporated and all of its Regional, State and Local Body, Entity, Organization, Chapter, Advisor, Officer or Member thereof, for any claim of injury and/or damages arising there from, including legal fees incurred to the organization.

SECTION V – PROPERTY

I concede that upon concluding or terminating the intake process of Psi Sigma Phi Multicultural Fraternity, Inc., I will return all property (Uniform, Book Bag, Notebook OR any property) issued to me by Psi Sigma Phi upon request. Failing to do so will result in breach of this contract. I also acknowledge that the intake fee of $500 paid to Psi Sigma Phi Multicultural Fraternity, Inc. will not be returned to me.

SECTION VI – SEVERABILITY

In the event that any section of this Agreement is rendered void as against civic Policy or as against the laws of any particular jurisdiction, it is agreed that the remaining clauses of this Agreement, will remain in full power and result.

SECTION VII – AFFIRMATION

The undersigned Prospective Member affirms that he has read this document, which includes the Psi Sigma Phi Multicultural Fraternity, Incorporated Anti-Hazing and Anti-Pledging Policy and that he fully understands the contents thereof, and verifies that he has not in any way, form or fashion been coerced, forced or made any promises to sign this document and that he has signed the same of his own accord and of his own free will.

AFFIRMATIONS 1, 2 & 3
1. I have read the Fraternity’s Definition of Hazing, Declaration of Purpose and Acknowledgement of Anti-Hazing Policy above and agree to observe its prohibitions and comply with its contents.

2. I have read this section on Acceptance of Responsibility and agree to accept responsibility for my own actions and conduct in connection with the Membership Intake Process and assume liability, were I to allow myself to be subjected to acts established to be Hazing, including injuries and damages, and any legal fees which the Organization has to pay arising from my actions or inaction as a Prospective Member.

3. I affirm that I am of sound body & mind & do hereby testify that I am physically well. I have no medical problems that can or will prohibit me from any activities

AFFIRMATION #1 Acknowledgement *
Required
AFFIRMATION #2 Responsibility *
Required
AFFIRMATION #3 Physical *
Required
Affidavit of Health
Please list all medications, allergies, or any other medical related issues that may affect your ability to participate in the educational process.
Health Status *
Form Submission
I have agreed to submit this application by electronic means. By signing this application electronically, I certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge, including information provided about the citizenship or alien status for each household member applying for benefits.
I also certify that:

I understand the questions and statements on this application.
I have read and understand the legal information.
I understand the penalties for giving false information or breaking the rules.
I understand that the agency may contact other persons or organizations to obtain needed proof of my eligibility and level of benefits.
I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.

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