Phi Mu Fraternity - Potential New Member Reference Form

NOTE: This is a confidential form, for use only by members of Phi Mu. If possible, attach a photograph and leadership/activities resume from the potential member. Even if you do not wish to endorse the potential member for membership, please complete as thoroughly as possible and return to the collegiate chapter, attention Membership Director. Visit for chapter contact information. You may use additional pages and attach them to this form if necessary.

Potential New Member’s Information

Name
Last First Middle
Home Address
Street City State Zip
Telephone / E-mail
Address
College/University Attending / Birthday
MM/DD/YYYY
(123) 555-1212
Classification / Freshman Sophomore Junior Senior
Parent(s) or guardian(s)
High School
Year Graduated / Size of Class / *Rank in Class
*Cumulative GPA / ACT Score / SAT Score
(If available) / (If available)
Please list potential member’s siblings, including ages, college attending, and Greek affiliations
Please list potential member’s Phi Mu relatives (full name, including maiden)
Full Name
(including maiden) / Relationship / Address / City / State / Zip
Full Name
(including maiden) / Relationship / Address / City / State / Zip
Full Name
(including maiden) / Relationship / Address / City / State / Zip
Full Name
(including maiden) / Relationship / Address / City / State / Zip

*Under the Family Education Rights Act of 1974, written authorization is required from the potential member before any information

from an institution of higher education, college, school or other related organization may be obtained.

Leadership and Activities

Potential contribution to Phi Mu: (Please provide information about the potential member’s leadership ability, personality and character as it relates to contributions she could make to Phi Mu. Please include the potential member’s special talents, interests and any other information that will assist the chapter in getting to know her better.)

Activities:(Please list names of organizations with the potential member’s participation and leadership in each one. Attach additional information on a separate sheet if necessary.)

Other: (Please list anything else it would be important to know.)

Phi Mu Recommendation

This form was: Solicited by chapter Sent voluntarilySolicited by the PNM

Classification of Information:

I am personally acquainted with the potential member and endorse her for membership.
I am willing to have chapter membership selection board unanimously decide endorsement for this potential member since I do not know her personally, do not know her well or am a collegian.
I am personally acquainted with potential member and do NOT endorse her for membership. If clarification is needed, the chapter adviser may contact me.
I obtained unanimous approval by an Alumnae Panhellenic for this potential member and/or members of three other sororities (name them) who would recommend this potential member to their chapters, thereby constituting an endorsement for membership.
Completed by / Chapter of Initiation / Year Initiated
Full Name (including maiden)
E-mail / Telephone
(123) 555-1212
Address
Street / City / State / Zip
Are you a current member of a(n) / Alumnae Chapter / Chapter Association / Forever Faithful
If so, please list alumnae chapter and/or chapter association
Check all that apply
Alumna / Collegian (info only) / Foundation Member
Foundation Giving Program Member:
- 1852 Society
- Legacy League
- Carnation Club
- Rose and White
Current or former national/area officer / List position(s) & year held
Advisory Council member / List chapter & position on council
Signature / Date