You are on page 1of 2

Attach 2x2

Color Picture
with printed name
at the back

NON-FRATERNITY CONTRACT
(This form is for UNDERGRADUATE STUDENT only)

Note: Please submit your duly accomplished and notarized NFC Form at SDFO Rm. 115B of St. Miguel Hall

I, (SURNAME, FIRST NAME, MIDDLE NAME) ________________________________________________________________,


(NATIONALITY) _______________________, with Degree Program and ID No.
____________________________, from the College of ___________________, born on (DATE OF BIRTH)
___________________________________
and with residence and postal address at _______________________________________________
____________________________________________ with the contact number _______________________,
from (LAST SCHOOL ATTENDED)_______________________________________________________________________, after having been
duly sworn to in accordance with law, hereby depose and state that:

Please CHOOSE ONE statement which APPLIES to YOU and MARK IT with an X :

1.1 ______ I am not a member of any fraternity, sorority or organization not recognized by the De La
Salle University (hereinafter called the UNIVERSITY);
OR

1.2 ______ I am a member of _____________________________________Fraternity/Sorority,


Organization not recognized by the UNIVERSITY, but attached is a written undertaking to quit, to
resign or to renounce my membership from said Fraternity/Sorority, Organization not recognized
by the UNIVERSITY that I have accomplished and I am submitting to the UNIVERSITY;

2. For the duration of my entire stay in the University, I shall not join any fraternity or organization not
recognized by the UNIVERSITY;

3. I acknowledge and understand that my admission to the University is a privilege and not a right and that
the UNIVERSITY has the right and authority to choose the persons or individuals that may be admitted
as students of the UNIVERSITY.
4. I acknowledge and understand that the University has likewise the authority to prescribe rules and
regulations governing non-membership of students in any fraternity, sorority, or organization in the
UNIVERSITY and that these rules are valid because they are based on the constitutional right of
schools of higher learning to prescribe the conditions they may require of any person or individual
aspiring to become their student as well as public policy as follows:
4.1 The recognition by the Government of the right of schools of higher education such as the
UNIVERSITY to withhold recognition to fraternities, sororities or organizations considered inimical to
peace and order in school campuses.

4.2 The general belief that formation of exclusive organizations or groups in the UNIVERSITY is disruptive
of the unity and peace the UNIVERSITY wishes to foster among members of the academic community.

4.3 The general belief that the presence of fraternities, sororities or organizations not recognized by the
UNIVERSITY has contributed to the violence experienced on campus.
Edited 03-03-15
Page 1 of 1
(Front Page)
4.4 The general perception that membership in fraternities, sororities or organizations not recognized by the
UNIVERSITY has developed hardened characters among its students that is contrary to the UNIVERSITY
MISSION STATEMENT.

4.5 The general belief that the absence of fraternities, sororities or organizations not recognized by the
UNIVERSITY helps in the broadening of friendship among Lasallians and eliminates the divisive effects of
exclusive organizations.

5. I recognize and accept that my continued stay in the UNIVERSITY is subject to my compliance with
prescribed discipline policies, rules and regulations especially with my non-membership in
fraternities, sororities or organizations not recognized by the UNIVERSITY.

6. I understand and accept that the UNIVERSITY can:

6.1 invite me for a random interview regarding the NFC or for any incident related to fraternity,
sorority or any unrecognized organization in which my name may be allegedly implicated;
and

6.2 either dismiss or expel me if I would be found having violated the conditions to this affidavit
as well as having falsely certified any information stated herein.

7. I am executing and submitting this affidavit as a prerequisite of my admission as a student of the


UNIVERSITY.
________________________________
PRINTED NAME & SIGNATURE OF STUDENT

========== = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = =
ONLY IF STUDENT IS OF LEGAL AGE: ONLY IF STUDENT IS A MINOR:
(At least 18 years old) (Below 18 years old)
______________________________________ Assisted by:
Signature over Printed Name _____________________________________
Student’s GOVERNMENT-ISSUED ID: Parents or Guardian’s
Signature over Printed Name
Type of ID: ____________________________ Parent’s/Guardian’s GOVERNMENT-ISSUED ID
ID No.: _______________________________ Type:______________________________
Date of Issue: __________________________ ID No: __________________________________
Place of Issue: __________________________ Date of Issue: _____________________________
Date of Expiration: ______________________ Place of Issue: ____________________________
Date of Expiration: ________________________

SUBSCRIBED AND SWORN TO BEFORE ME on this ______ day of _______________, in


_______________ (city/municipality/province), by the above student and/or parent/guardian, exhibiting to me the
above-stated valid ID.
WITNESS MY HAND AND SEAL on the date and place first, mentioned.

STUDENT’S THUMBMARK (NOTARY PUBLIC)


LEFT RIGHT
Doc. No. _______________
Page No. _______________
Book No.______________
Series of ______________

Edited 04-17-18
Page 2 of 2
(Back Page)

You might also like