2020
Graduate
Advisors’
Certification
Training
Application
Name:__________________________________ Financial #:_____________
Address:________________________________________________
City and State:__________________________________
ZIP:_________
Email:__________________________________ Phone:_________________
Graduate Advisor certification expiration date (if applicable): ______________
Location of Training (only pick one)
Level l or ll
2020 ____________________ Regional Conference
(insert name of region)
2020 Boule, Philadelphia PA
AFFIDAVIT (Must be signed in presence of notary)
Who must receive a Graduate
Advisor Certification?
Candidates for advisor to an
undergraduate chapter
• Members of the chapter’s
Graduate Advisory
Committee
• Sorors in chapter leadership
positions (Optional)
• Sorors planning to pursue
international offices
What is the Graduate Advisors’
Certification?
•
•
•
LEVEL I – an introductory
training for Graduate
Advisor candidates,
Graduate Advisory
Committee Members, sorors
in chapter leadership
positions who never
certified, and sorors who
have allowed their
certification to expire.
LEVEL II – an intermediate
training for Graduate
Advisor candidates,
Graduate Advisory
Committee Members, and
sorors in chapter leadership
positions seeking to recertify
within the effective period of
their certification.
I, (insert name) _______________________, DO HEREBY SWEAR OR
AFFIRM THE FOLLOWING:
I
have
been
a
member
of
(insert
graduate
chapter)
_________________________________ Chapter for at least two
consecutive years [24 months of active membership as defined by
Corporate Office] immediately as of February 1, 2020; I have never been
suspended for hazing; I attended the 2016 or 2018 Boule and/or a 2018 or
2019 Regional Conference; and I am aware that 2020 Regional conference
and 2019 Leadership Seminar does not count toward conference
attendance.
Conference Attended: _________________________
Month/Year Attended: _________________________
Signature: __________________________ Date signed: _____________
NOTARY PUBLIC (Please sign below & stamp/seal to the right)
Signed and sworn before me on this _______day of _________________,
20_____.
Notary Signature: _____________________________
Commission Expiration Date: ____________________
CHAPTER VERIFICATION STATEMENT:
Based on chapter
records/documents, I hereby affirm that this applicant has met the
requirements for Graduate Advisors’ Certification Training – (1) there are
no chapter records of the applicant ever having been suspended for hazing;
(2) the applicant has been a member of this graduate chapter (including
Life Members) for at least two consecutive years [24 months active
membership as defined by Corporate Office] immediately as of February 1,
2020; and (3) has attended 2016 or 2018 Boule and/or a 2018 or 2019
Regional Conference.
Printed/Signed Name of Basileus: _______________/_______________
AND
Printed/Signed Name of Grammateus:____________/________________
Date:______________________