PLEDGE REGISTRATION FORM Please read carefully, sign where appropriate, and Fax this form to The Kappa Zeta Psi Fraternity Customer Service Number @ (530)654-7706.
Kappa Zeta Psi Fraternity
Pledge Registration Form
Social Security No.:________________________________
Full Name:__________________________________________
Home Address:_______________________________________
____________________________________________________
Have you ever pledged a college fraternity?_____________
If so, give date (month/year):_________________
Name of Fraternity:_________________________________ College:_________________________________
Please read carefully and sign where appropriate.
I realize by signing this form and paying the Pledgee fee I am indicating my willingness to be Plegded by Kappa Zeta Psi Fraternity. I certify that all the information is true. I further realize that by signing this form I am indicating that I will abid by the Rules set forth by Kappa Zeta Psi Fraternity during the pledge period. I realize that failure to abide by any such policies will result in my dismissal from the Pledge Program. Further, I hereby authorize the release of my academic records contained on this sheet to Kappa Zeta Psi Fraternity for the purpose of compliance with scholastic requirements.
Include the $40.00 Pledgee Registration Fee, which is MANDATORY and non-refundable. Registration after August 9, add an additional $10.00 Make checks payable to Kappa Zeta Psi Fraternity.
