THETA CHI FRATERNITY Nomination Form for Alumnus Initiate Chapter submitting nomination: __________________________________________________________________ College/University: _____________________________________________________________________________ Nominee’s Full Name: __________________________________________________________________________ Home Address: ________________________________________________________________________________ (Street) (City, State, Zip) Age: _______ If married, name of spouse:___________________________________________________________ College/University Attended: _____________________________________________ Yr of Graduation: ________ Degree(s): ____________________________________________________________________________________ Business/Profession: _______________________________ Position/Title: ________________________________ Membership in organizations and clubs: ____________________________________________________________ Has he ever pledged or been initiated in to another college fraternity? Yes ___ No ___ Please describe current and future involvement of the nominee with the chapter: (Attach at least a half page letter to the form citing the reasons for your nomination.) Has he been elected unanimously by the chapter? Yes ___ No ___ Date of Meeting: ____________ Is the chapter’s request to make the proposed an alumnus initiate in compliance with The Constitution and Bylaws of Theta Chi Fraternity, Inc. (see next page)? Yes ___ No ____ Application approved by (please sign on appropriate line): Alumnus Adviser: ______________________________________________ Date: _________________________ Chapter President: _____________________________________________ Date: _________________________ Chapter Secretary: _____________________________________________ Date: _________________________ All alumnus initiates must be approved by the Executive Director BEFORE initiation Intended date of initiation if approved by the Executive Director: _______________________________________ =============================================================================== FEE INFORMATION FOR ALUMNUS INITIATES The initiation fee for an Alumnus Initiate is $250.00 Upon receipt of this form and payment in full, the alumnus initiate will receive a membership Badge, membership certificate, pocket membership card, and a copy of The Manual of Theta Chi. Return this form and all fees to: Theta Chi Fraternity PO Box 503 Carmel, IN 46082 Rev.1-21-2016 Is the chapter’s request to make the proposed nominee an alumnus initiate in compliance with The Constitution and Bylaws of Theta Chi Fraternity, Inc.? We have inserted below the criteria listed in Article VI, Section 5: Please checkmark at least three (3) of the boxes. Article VI, Section 5: a) In order to be initiated as an alumnus member of the Fraternity, an individual not already initiated as an undergraduate member shall, in addition to meeting the qualifications set forth in Section 1 of this Article VI, qualify under not less than three of the following criteria, and shall not be a member of another similar fraternity: (1) He shall be a person of distinction by virtue of outstanding character proven over a long period of time; (2) He shall have been the recipient of an earned or honorary degree from a duly recognized college or university (3) He shall be a member of the faculty, staff or board of directors of an institution at which an active chapter exists; (4) He shall have demonstrated an unusual degree of interest in and affection for one or more active chapters; (5) He shall be an alumnus of, or enrolled in a graduate school of, an institution at which an active chapter exists; and (6) He shall be the grandfather, father, step-father, uncle, cousin, brother, or guardian of a new member or member. .