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Personal Information
First Name: Middle Name: Last Name:
Student ID Number: Birth Date: January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986
Winthrop Address: Winthrop Phone Number:
Email Address:
Education
Major: Classification: Freshmen Sophmore Junior Senior High School:
Other Colleges Attended: College GPA:
Activities and Honors
Please list any High school and College Activities, and any Awards and Honors you have received:
Affiliations
Have you ever been in a National College Fraternity? Yes No
If yes: What Fraternity?
When were you Initiated? January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
When was your membership terminated? January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986
Relatives in Fraternities
Please list below any Parents, siblings, Grandparents, Aunts, Uncles, or any other relatives. Please list their name, their relation to you, what fraternity they were in, and what University they attended: By Submitting this form, I herby confirm that the above information provided to the Greek Life Office at Winthrop University for spring and fall recruitment is, to the best of my knowledge, correct. In addition, I consent to the release of confidential data including earned hours and grade information. I am also aware that an additional copy of my registration form will be provided to the fraternity chapters of the Winthrop University IFC.
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