Undergraduate Alumna Status

Application
Step 1: Application
A financially current undergraduate member who is unable to meet the obligations of chapter membership may
complete this section and submit the application to the Chapter President and the Alumnae Advisory Committee (AAC)
Chair.
Applicant Chapter
First, middle and last name
Permanent home address
Street City State ZIP

Phone number Email

Date of initiation Current School year
classification
Month and year
I am requesting that I be granted undergraduate alumna status
to be effective
Fall, winter or spring and year
“I have met all Fraternity obligations including paying all chapter and Fraternity dues and fees. I do not have a signed
housing contract for the current or upcoming academic year. I submitted payment in Greekbill for the Fraternity alumna
dues ($35), which are the first-year annual alumna dues. I must continue to meet Fraternity obligations until the term for
which I have been granted Undergraduate Alumna Status (UAS) begins. I understand my application may be denied. If
my application is denied, the chapter will refund the Fraternity alumna dues. If granted UAS, I understand as an alumna
member I cannot attend or participate in any chapter functions for collegiate members, which include but are not limited
to chapter meetings, social functions, sisterhoods, meals at the chapter house, etc. If circumstances change, and I’m able
to be an active member of the chapter again, I understand I must gain approval from the AAC to return.”
Applicant Signature Date
I am requesting UAS for the following reason (please X the appropriate box and answer supplemental questions):
Ill health as certified by a physician
Nameof
Name of Pysicisn
Physician:

City State
I have included a letter from my
physician
Documented extreme or unforeseen financial stress
*Unforeseen can be defined as not anticipated or predicted, a change in priorities is not an unforeseen change.
Date financial situation
changed
Amount of tuition per semester for your
college or university
How do you pay for tuition Self Family Scholarships/Grants/Loans
(check all that apply) Support

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 Amount of scholarships received for semester
currently enrolled
Estimated amount of scholarships to be received
for the upcoming semester
Amount of grants received for semester currently
enrolled
Estimated amount of grants to be received for the
upcoming semester
Amount of loans received for semester currently
enrolled
Estimated amount of loans to be received for the
upcoming semester
Do you currently hold a No
job? Yes
If yes, where do you work and
how many hours per week?
If no, why do you currently
not hold a job?

Will you have a job next Yes No

semester?

In five sentences or less provide any additional details of the extreme or unforeseen change in
circumstance. This explanation may be submitted in a separate document if more room is needed. Please note
that a change in priorities is not considered an unforeseen change. This includes but is not limited to a change in major, tuition, etc.

Academic Requirements

Internship
Attach proof of course credit for internship, describe the internship and explain why you need UAS:

Student Teaching
Attach proof of course credit for student teaching, and explain why you need UAS:

Obtaining Minimal Credit Hours

Does your University require a minimum amount of credit hours to be involved in a student organization?
Yes No
If yes, please share a copy of your University’s policy.
If no, please explain why your credit hours affects your involvement with the chapter:

Other Academic Requirement

Please explain:

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 Affiliate

Did you affiliate to this chapter from another chapter? Yes No

Other

In five sentences or less, explain why you will be unable to participate in Pi Beta Phi activities for the
remainder of your undergraduate career. This explanation may be submitted in a separate document if more
room is needed.

Step 2: Vice President of Finance

Has the member been invoiced for her alumna Yes No
dues?
Is the member financially current? Yes No Date confirmed in
Greekbill
Does the member have a signed housing Yes No
contract for the current or upcoming academic
year?
Signed by Vice President of Finance Date

(continued on next page)

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Step 3: Alumnae Advisory Chair or Financial Advisor
Is the member financially current, Yes No
including payment of Alumna Dues?
Does the member have a signed housing Yes No
contract for the current or upcoming
academic year?
Date confirmed in Greekbill

I certify that I have reviewed this application and that to the best of my ability, I agree that this woman should be granted UAS status.

Signed by AAC Chair or Financial Advisor Date

Step 4: Alumnae Advisory Chair Final Approval

Is the member approved for UAS for
the requested term? Yes No

I certify that I have reviewed this application and that to the best of my ability, I agree that this woman should be granted UAS status.

Signed by AAC Chair or Financial Advisor Date

If approved: AAC Chair must upload the application in eReports and submit a “UAS” transaction.

If denied: AAC Chair must notify the member of the denial.

Step 5: Final Approval

After AAC approves the application and submits to eReports, Headquarters (HQ) will review and make the final
approval.

If approved: HQ will email the AAC Chair letting her know the transaction was approved.

If denied: HQ will work with the Collegiate Regional Membership Specialist who will work with AAC Chair on next
steps.

Returning from UAS

If a member wishes to return to the chapter roster after previously being approved for UAS, to participate as
an undergraduate in good standing again, she can apply by sending a statement of her intent to AAC. Approval
for return would be given by AAC.
Conditions in which returning to the roster would be approved are:
•   Member’s health has improved
o   Doctor’s note required
•   Financial hardship resolved
•   Academic requirements met
o   Internship o   Additional Credit Hours
o   Student Teaching o   Other
•   Other reason

NOTE: For additional information on the correct procedure for handling UAS applications, refer to the Membership Status Guide under the
Vice President of Membership or Vice President of Administration’s resources on the Resource Library.

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