PHI IOTA ALPHA FRATERNITY, INC. BETA CHAPTER, BROOK For more information log on to or call CRITERIA / REQUIREMENTS or call (347)

PHI IOTA ALPHA FRATERNITY, INC. BETA CHAPTER, BROOK For more information log on to or call NAME: DATE OF BIRTH: ACADEMIC STATUS: ADDRESS: CITY:STATE:ZIP: HOME PHONE: SCHOOL PHONE: CUM GPA (4.0 Scale) : ETHNIC BACKGROUND (Optional) : By signing this application, I affirm that the documentation I am submitting is accurate to the best of my ability. If any information is found to be inconsistent or inaccurate, I do understand that I will be disqualified from the competition. Signature Date PART I – GENERAL INFORMATION Freshmen Sophomore Junior Senior or call (347)

PHI IOTA ALPHA FRATERNITY, INC. BETA CHAPTER, BROOK For more information log on to or call DON JOSE MARTI – BIOGRAPHY or call (347)