TAU GAMMA SIGMA

TRISKELIONS’ GRAND SORORITY

PUROK QUATRO COMMUNITY CHAPTER

BATCH NAME: _______________________________ BATCH DATE: ____________

ALEXIS NAME: _________________________________________________________

ADDRESS:______________________________________________________________
AGE: _________________________ BIRTHDATE:_____________________________
CONTACT NO. : _______________ EMAIL ADD: _____________________________
MOTHER’S NAME: ______________________________________________________
FATHER’S NAME: ______________________________________________________

Do you have any medical records to assure your physical and mental health? (Please
provide details if YES) YES____________ OR NO _____________

Give one valid reason why you have decided to join TAU GAMMA SIGMA GRAND
SORORITY.

Do you subject yourself voluntarily to undergo the necessary procedure in accordance to

the fraternity? YES_______ NO_______ (Please give reason if NO)

I hereby state that all of the above information are the true and correct to the best of my
knowledge the fraternity is not liable for any wrong information that can or might be
harmful to my own being.

SIGNATURE OVER PRINTED NAME

ACCEPTED: YES_______ NO _________
BY: __________________________