OMICRON ZETA PHI

FRATERNITY & SORORITY

SMC/SDSSU CANTILAN CHAPTER
Cantilan, Surigao del Sur

1. Name: Alias / Nickname:

2. Address: Date of Birth:
3. Course: Name of school & Place:
4. Civil Status: Number of dependent:
5. Fathers name: Address:
6. Mothers name: Address:
7. Business address:
8. Name of person to be notified in case of emergency:
9. Identification Marks:
10. Height: Weight:
11. Home Address:
12. School Attended:

13. Previous Fraternity / Sorority Experiences:

14. Dialect and Language Spoken:
15. Main Occupation:
Employer and Address:
Working hour?
16. Civic / School Organization / Sorority:
a.
b.
17. Best qualified sports game:
18. Have you ever been convicted of any crimes? If so, state nature of the
case:
19. Are you willing to undergo rigid initiation if so sate you reason;

20. Are you willing to obey without question and accept duties and responsibilities imposed to
you by you Master / Lady?

(Signature of Pledgee)

(Signature of Interviewer)

DATE SURVIVED:
 OMICRON ZETA PHI
FRATERNITY & SORORITY
SSIT/SMC/SDSSU CANTILAN CHAPTER
Cantilan, Surigao del Sur

AFFIDAVIT

I hereby myself voluntarily

joined the initiation and suffer myself to received panicious initiation from my Master / Lady
Omicronians.

Whatever happen to me nobody is concerned.

Undersigned of the above for proper guidance and information or to anybody.

(Pledgee)

(Master / Lady Initiator)

(Master / Lady)

DATE SURVIVED:

OMICRON ZETA PHI

FRATERNITY & SORORITY
SSIT/SMC/SDSSU CANTILAN CHAPTER
Cantilan, Surigao del Sur

AFFIDAVIT

I hereby myself voluntarily

joined the initiation and suffer myself to received panicious initiation from my Master / Lady
Omicronians.

Whatever happen to me nobody is concerned.

Undersigned of the above for proper guidance and information or to anybody.

(Pledgee)

(Master / Lady Initiator)

(Master / Lady)

DATE SURVIVED: