Last Name: First Name:
Middle Name: Social Security Number:
Campus Phone #:
University Address
Street, Apt., or Residence Hall and room #:
T-Box:
Home Address
Street: City: State: Zip:
HM Phone #: High School Attended:
Major Field of Study: College Hours Completed:
Present Classification: Freshman Sophomore Junior Senior
Are you a transfer student from another college? Yes No
If so, from where?
Have you ever been initiated into a national social fraternity? Yes No

In order to be eligible for pledging/association, an individual must:
1. be officially enrolled at TSU
2. not be on disciplinary probation
3. not have been an active member of an IFC recognized fraternity at TSU or any other college or university
4. have a 2.25 GPA or a high school average of an eighty (80) or equivalent (high school average only counts for those students who have completed less than nine (9) hours of college credit)
5. be a full time University student (12 hours)
6. turn in the most recent copy of his transcript (incoming freshmen need a copy of their high school transcript)
7. complete this form in its entirety

Any male student, regardless of race, color, religion, or creed who meets the rushee regulations, shall be able to be rushed by Delta Chi.

I certify that the above information is correct and complete to the best of my knowledge and that I am eligible for pledging/association according to the criteria listed above.
I authorize TSU to release my grade point average to IFC and its member fraternities.