Attach 2x2

Color Picture
with printed name
at the back

NON-FRATERNITY CONTRACT
(Graduate Student)
Note: Please submit your duly accomplished and notarized NFC Form at SDFO Rm. 105 or Rm. 118 of St. Joseph Hall

I, _______________________________________________, ____________________ (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 mark the appropriate statement with X)
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
______ 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.
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(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 either dismiss or expel me if I would be
found having violated the condition 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

========== = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = =

_______________________________________
Signature over Printed Name
Students GOVERNMENT-ISSUED ID:

Type of ID: ____________________________

ID No.: _______________________________
Date of Issue: __________________________
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.
STUDENTS THUMBMARK
LEFT

RIGHT

(NOTARY PUBLIC)
Doc. No. _______________
Page No. _______________
Book No.______________
Series of ______________

Edited 04-09-2013
Page 2 of 2
(Back Page)