ALPHA PHI ALPHA FRAT ERNIT Y, I NC.
®
| 2313 ST. PAUL ST. BALTIMORE, MD 21218
ATTACHMENT A - REQUEST FOR INITIAL MEMBERSHIP DEVELOPMENT
General Information Chapter Name: Chapter Seat: Are all officers IMDP certified
Chapter Tax:
Yes
No
Chapter Key:
% of Chp Brothers IMDP Certified (min 50%)
Give the date the following items were paid or submitted Chapter Insurance: Chapter Directory & Report:
For the following conventions/conferences, give the ratio of Chapter Bros: (registered) vs (delegate strength) Regional Conv: / General/Special Conv: /
GTHGTC*
Give the date(s) you executed the following National Projects/Programs within the past year (*=Mandatory) VPHP* Project:Alpha* Brothers’ Keeper
Is the chapter currently on probation, suspension or have outstanding fees or taxes to the university and or fraternity? If yes, please explain.
Yes No
Are any Brothers in the chapter on probation or suspended by the college/university or fraternity? If yes, provide name(s), and date(s):
Yes
Does your chapter have unpaid fines as a result of a fine(s) of a brother(s)? If yes, please explain.
Yes
No
No
College Chapters Only: Chapter GPA (cumulative)
/4.0
Alpha Advisor’s Name Alpha Advisor’s Chapter
Alpha Advisor Information Date Alpha Advisor Certified Date IMDP Certified
Alumni Chapters Only: Does Your Chapter have a Reclamation/Retention Plan? If so, describe it. If not, explain why?
Total number of active Brothers in your Chapter How many Brothers initiated within the past 3 Fraternal years
Page 2 of 4
How many Brothers have been reclaimed within the past Fraternal year How many Brothers initiated within the past 3 Fraternal years are ACTIVE
Yes
Reclamation % Increase Retention %
No
Revision 2011-12-07