Semester: * Spring Summer 1 Summer 2 Fall Semester Year: * 2012 2013 2014 2015 2016 2017 2020 Organization Joined: New Member Name: Permanent Address: Phone: Email: Local Address: INFORMATION RELEASE I hereby authorize the Program Coordinator for Greek Life to examine the academic records for each semester of my undergraduate matriculation to determine if I meet the academic criteria for affiliation/participation in activities as established by the Interfraternity Conference, the Multicultural Greek Council, the National Pan-Hellenic Council or the Panhellenic Association. I also understand that my grades may be furnished upon request to the Fraternity/Sorority national organization and association, their designated regional/local representative, or to the chapter president for the purpose of establishing eligibility for selection/participation in various University, community, and chapter related activities. I Agree Do Not Send Check here if you do NOT want the Office of Student Activities, the Temple University Greek Association, or affiliate councils to mail information to the permanent address provided above. What code is in the image? * Enter the characters shown in the image.
