Acknowledgment Page and Submission Checklist - Theta Xi Fraternity
Acknowledgment Page and Submission Checklist - Theta Xi Fraternity
Acknowledgment Page and Submission Checklist - Theta Xi Fraternity
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2009 – 2010 Annual Report to the <strong>Fraternity</strong><br />
<strong>Submission</strong>s <strong>Checklist</strong> <strong>and</strong> <strong>Acknowledgment</strong><br />
Deadline for submission of all materials is Tuesday, June 1, 2010.<br />
Date: ____________________<br />
Chapter/Colony Name: ________________________________________________________________<br />
Completed/Submitted By: ______________________________________ Roll #: ________________<br />
Title: _______________________________________________________________________________<br />
Email Address: ________________________________ Phone: _______________________________<br />
All submissions should be placed in a three-ring folder or binder with the<br />
following completed pages as the cover page for the submission.<br />
If you have any questions about completing any portion of the Annual Report to the <strong>Fraternity</strong><br />
(including the online submission), please contact Director of Operations<br />
Ron Trucks at ron@thetaxi.org or at 314-993-6294 x103.
Acknowledgement Statement (Required)<br />
We certify that all information contained in this Annual Report to the <strong>Fraternity</strong> is true <strong>and</strong> accurately<br />
depicts our chapter/colony’s operations <strong>and</strong> accomplishments this school year. We also certify that, to<br />
the best of our knowledge <strong>and</strong> without purpose of evasion, this chapter/colony is in full compliance<br />
with:<br />
• <strong>Theta</strong> <strong>Xi</strong> Risk Management Policy (see The Quest, pages 115-116 in the 2010 25 th edition)<br />
addressing alcohol <strong>and</strong> drugs; prohibition of hazing; sexual abuse; fighting <strong>and</strong> violent behavior;<br />
fire health <strong>and</strong> safety; <strong>and</strong> ongoing risk management education<br />
• M<strong>and</strong>atory use of Alpha Nine Core Program (see The Quest, pages 8-10 in the 2010 25 th edition)<br />
for the foundation of our chapter’s colony’s membership education program<br />
• <strong>Theta</strong> <strong>Xi</strong>’s Statement of Position on Expansion (By-Law 29.5 of the Constitution <strong>and</strong> By-Laws of<br />
<strong>Theta</strong> <strong>Xi</strong> <strong>Fraternity</strong>) to support colonization efforts by members of the North-American<br />
Interfraternity Conference to provide a fraternity experience for qualified undergraduates on<br />
this campus<br />
All signatures are required in order for any award application to be accepted.<br />
We, the undersigned officers of the _______________________ Chapter/Colony of <strong>Theta</strong> <strong>Xi</strong> <strong>Fraternity</strong>,<br />
affirm the accuracy of this Annual Report to the <strong>Fraternity</strong> on the _________ day of _________, 2010.<br />
(ex. 15th day of June 2010)<br />
Officer Printed Name Signature<br />
President _________________________ _____________________________<br />
Vice President _________________________ _____________________________<br />
Treasurer _________________________ _____________________________<br />
Secretary _________________________ _____________________________<br />
Membership Educator _________________________ _____________________________<br />
Scholarship Chairman _________________________ _____________________________
ACRREDITATION SECTION<br />
<strong>Submission</strong><br />
Number<br />
Required For…<br />
Additional Information…<br />
Chap/Col ATM St<strong>and</strong>ard Question # Comments<br />
AC1 X X Ritual 5<br />
AC2 optional optional<br />
Membership<br />
Education<br />
AC3 X X Scholarship 7<br />
AC4 X X Scholarship 8<br />
AC5 X X Finances 3<br />
10<br />
Areas to be highlighted on<br />
the submitted Chapter /<br />
Colony Bylaws<br />
Included?<br />
AC6 X X Finances 5<br />
AC7 X X<br />
AC8 X X<br />
Campus &<br />
Community<br />
Relations<br />
Campus &<br />
Community<br />
Relations<br />
2, 3, 4 & 5<br />
AC9 if housed if housed Housing 2<br />
AC10 X X<br />
Alumni<br />
Relations<br />
6<br />
7<br />
May be submitted online or<br />
included in packet<br />
online or packet?<br />
AWARDS SECTION<br />
<strong>Submission</strong><br />
Number<br />
Required For…<br />
Additional Information…<br />
Chap/Col ATM St<strong>and</strong>ard Question # Comments<br />
AW1 Ritual 2<br />
Included?<br />
AW2 Recruitment 7<br />
AW3<br />
Membership<br />
Education<br />
AW4 Scholarship 2<br />
AW5 Scholarship 6<br />
AW6 Scholarship 8<br />
5<br />
Areas to be highlighted<br />
on the submitted<br />
Chapter / Colony Bylaws<br />
AW7 Finances 2<br />
AW8 Finances 8<br />
AW9 Chapter Operations 2<br />
AW10 Chapter Operations 10
<strong>Submission</strong><br />
Number<br />
Required For…<br />
Additional Information…<br />
Chap/Col ATM St<strong>and</strong>ard Question # Comments<br />
AW11 Chapter Operations 12<br />
AW12<br />
AW13<br />
AW14<br />
X<br />
X<br />
Campus &<br />
Community<br />
Relations<br />
Campus &<br />
Community<br />
Relations<br />
Housing (chapters<br />
with house)<br />
AW15 Alumni Relations 2<br />
5<br />
12<br />
6<br />
Areas to be highlighted<br />
on the submitted<br />
Chapter / Colony Bylaws<br />
Areas to be highlighted<br />
on the submitted<br />
Chapter / Colony Bylaws<br />
Included?<br />
AW16 Alumni Relations 4<br />
AS1<br />
Additional<br />
<strong>Submission</strong><br />
When finished…<br />
1. Copy all materials <strong>and</strong> keep a copy in your records<br />
2. Mail all documents (requesting delivery confirmation) by the Postal Service to:<br />
<strong>Theta</strong> <strong>Xi</strong> <strong>Fraternity</strong><br />
Accreditation Committee<br />
PO Box 411134<br />
St. Louis, MO 63141<br />
Or ship (via UPS, FedEx, etc.) to<br />
<strong>Theta</strong> <strong>Xi</strong> <strong>Fraternity</strong><br />
Accreditation Committee<br />
745 Craig Road, Suite 222<br />
St. Louis, MO 63141<br />
3. Email Amy Collins (amy@thetaxi.org) to notify her that you have sent the submission. Make<br />
sure to include the tracking number, if applicable.<br />
Deadline for submission of all materials is Tuesday, June 1, 2010.
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