2022 Graduate Advisors ’ Certification Training Application
Name : __________________________________ Financial #:_____________ Address : ________________________________________________ City and State : __________________________________
Choose Certification Level
2022 ________________ Regional Conference ( insert name of region )
Level l or Level ll
ZIP :_________ Email :__________________________________ Phone :_________________ Graduate Advisor certification expiration date ( if applicable ): ______________ Who is eligible to take 2022 Graduate Advisor Training ?
• 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
• Graduate Certification has expired or will expire in 2022 .
• Never suspended for hazing
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 .
AFFIRMATION STATEMENT REGARDING SORORITY SANCTION :
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 , 2022 ; I have never been suspended for hazing ; I attended the 2021 Boule , or 2020 or 2021 Regional Conference . By signing this form , I verify that all of the information I have provided is true and correct . I understand that Alpha Kappa Alpha Sorority , Incorporated ® can rescind any rights or privileges of a member based on the submission of false information or documents .
Conference Attended : _________________________ Month / Year Attended : ___________________ Chapter Name : _________________________ Region : ______________
Signature : __________________________ Date signed : _____________
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 that have paid current dues ) for at least two consecutive years [ 24 months active membership as defined by the Corporate Office ] immediately as of February 1 , 2022 ; and ( 3 ) has attended 2021 Boule , or 2020 or 2021 Regional Conference . I also affirm that I am not signing my own verification statement .
Printed Name of Basileus *: ______________________ Signature of Basileus : __________________________ Date :______ * Grammateus must sign if Basileus applies to training .