Fraternity Formal Recruitment Application The University of Southern Mississippi Full Name: Preferred Name: Social Security Number:   Classification: Mailing Address:  City: State: Select a State or Province Armed Forces Americas , USA Armed Forces Europe , USA Alaska , USA Alabama , USA Armed Forces Pacific , USA Arkansas , USA American Samoa , USA Arizona , USA California , USA Colorado , USA Connecticut , USA District Of Columbia , USA Delaware , USA Florida , USA Fed States of Micronesia , USA Georgia , USA Guam , USA Hawaii , USA Iowa , USA Idaho , USA Illinois , USA Indiana , USA Kansas , USA Kentucky , USA Louisiana , USA Massachusetts , USA Maryland , USA Maine , USA Marshall Islands , USA Michigan , USA Minnesota , USA Missouri , USA Mississippi , USA Montana , USA North Carolina , USA North Dakota , USA Northern Mariana Islands , USA Nebraska , USA New Hampshire , USA New Jersey , USA New Mexico , USA Nevada , USA New York , USA Ohio , USA Oklahoma , USA Oregon , USA Pennsylvania , USA Puerto Rico , USA Palau , USA Rhode Island , USA South Carolina , USA South Dakota , USA Tennessee , USA Texas , USA Utah , USA Virginia , USA Virgin Islands , USA Vermont , USA Washington , USA Wisconsin , USA West Virginia , USA Wyoming , USA Alberta , CAN British Columbia , CAN Manitoba , CAN New Brunswick , CAN Newfoundland , CAN Nova Scotia , CAN Northwest Territories , CAN Ontario , CAN Prince Edward Islands , CAN Saskatchewan , CAN Yukon Territory , CAN Quebec , CAN Not USA or Canada Zip:  Date of Birth: Age: High School G.P.A.: ACT/SAT Score: College G.P.A.: Local Address:  City: State: Select a State or Province Armed Forces Americas , USA Armed Forces Europe , USA Alaska , USA Alabama , USA Armed Forces Pacific , USA Arkansas , USA American Samoa , USA Arizona , USA California , USA Colorado , USA Connecticut , USA District Of Columbia , USA Delaware , USA Florida , USA Fed States of Micronesia , USA Georgia , USA Guam , USA Hawaii , USA Iowa , USA Idaho , USA Illinois , USA Indiana , USA Kansas , USA Kentucky , USA Louisiana , USA Massachusetts , USA Maryland , USA Maine , USA Marshall Islands , USA Michigan , USA Minnesota , USA Missouri , USA Mississippi , USA Montana , USA North Carolina , USA North Dakota , USA Northern Mariana Islands , USA Nebraska , USA New Hampshire , USA New Jersey , USA New Mexico , USA Nevada , USA New York , USA Ohio , USA Oklahoma , USA Oregon , USA Pennsylvania , USA Puerto Rico , USA Palau , USA Rhode Island , USA South Carolina , USA South Dakota , USA Tennessee , USA Texas , USA Utah , USA Virginia , USA Virgin Islands , USA Vermont , USA Washington , USA Wisconsin , USA West Virginia , USA Wyoming , USA Alberta , CAN British Columbia , CAN Manitoba , CAN New Brunswick , CAN Newfoundland , CAN Nova Scotia , CAN Northwest Territories , CAN Ontario , CAN Prince Edward Islands , CAN Saskatchewan , CAN Yukon Territory , CAN Quebec , CAN Not USA or Canada Zip:  Residence Hall Assignment: Room No.: Phone: Fraternity Legacy: NO YES If YES, what fraternity: Please list the last high school or college attended and activities, honors, or special talents (clubs, sports, awards, etc.) What is your planned major? Have you ever been part of a fraternity or Greek organization before? NO YES If YES, what organization? Are you interested in joining any other organizations on campus? (Example: SGA, Student Eagle Club, UAC, etc.) Select Option I AGREE I DISAGREE that all of the above information is answered to the best of my knowledge and I agree to release all high school and college transcripts to the office of Greek Life at the University of Southern Mississippi.

Citizenship - Friendship - Leadership - Scholarship
Last modified: Sunday, July 27, 2003 12:19:27 CDT
The University of Southern Mississippi
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