Greek Life - Chapter Member Disaffiliation Form

GREEK MEMBER - Removal Information

This form is to be completed when you disaffiliate from a fraternity or sorority at Syracuse University. Failure to complete this form will allow Greek Life to include you on chapter grade reports, and you will continue to be held to the guidelines and expectations from Greek Life.

This form will allow Greek Life to remove a student from their chapter's roster. After the form is submitted, Greek Life will contact the chapter president to confirm and then remove the name from the roster.

This form may be used at any point in time. It is only to be used for "permanent removal" not temporary removal and can be for a new member/associate or interest or an active member removal.

Name:

SU ID:

Name of the Fraternity/Sorority disaffiliating from:

Email Address:

Reason why you are disaffiliating (please be specific):

Were you fully initiated before you disaffiliated?

Yes

When did you disaffiliate from the chapter? (Please list date or month/year)

MEMBER ONLY:
Did you notify the chapter president that you are disaffiliating?

Yes