APO Pledge Program Form No.

6B
Revised: 02-07-18
Alpha Phi Omega
Philippines Incorporated

(Chapter)

(College/ University)

(Section) (Administrative Region)

Date: _____________________

Dear Sir / Madam:

Pursuant to Section 2 of Republic Act No. 8049, “An Act ‘Regulating Hazing’ and other
forms of initiation rites in fraternities, sororities, and organizations and providing penalties
therefore,” we are respectfully informing you that we shall conduct our PHI DAY on
_______________ at the _________________________________________.
(date) (Venue)

To see to it that no physical harm of any kind will be inflicted upon our Pledge Members,
kindly assign at least two (2) representatives from your office – as mandated by Section 3 Republic
Act No. 8049 – to be present during said initiation activity which will include activities stated in
the APO PLEDGE PROGRAM SCHEDULE that was received by your office on __________________.
(Date when APP Schedule was Submitted)
Thank You.

(Signature over Printed Name and ID Number) (Signature over Printed Name and ID Number)
GRAND CHANCELLOR/ FACULTY ADVISER
GRAND LADY CHANCELLOR

(Signature over Printed Name and ID Number)

SECTION CHAIR FOR COLLEGIATE

NOTED BY:

(Signature over Printed Name and ID Number) (Signature over Printed Name and ID Number)
REGIONAL DIRECTOR FOR COLLEGIATE REGIONAL DIRECTOR

Copy furnished:
APO Philippines Committee on Membership
Office of the National Vice President for the Fraternity Affairs
Office of the National Vice President for Sorority Affairs
Page 1 of 1