Petition for Expansion for Potential New Chapter

Name of University *

Location *

Total Enrollment *

Total Undergraduate Enrollment *

Total Graduate Enrollment *

Number of Student Organizations *

Number of Sororities *

Number of Fraternities *

Number of Service Organizations *

Name *
Contact person for petitioning group

Address *
Contact person for petitioning group

Phone *
Contact person for petitioning group

Email *
Contact person for petitioning group

Name *
Faculty/staff advisor for petitioning group

Title/Position *
Faculty/staff advisor for petitioning group

Address *
Faculty/staff advisor for petitioning group

Phone *
Faculty/staff advisor for petitioning group

Email *
Faculty/staff advisor for petitioning group

Name *
Please provide contact information below for a school administrator who is aware of your efforts to organize a chapter of Omega Phi Alpha on your campus.

Title/Position *
Please provide contact information below for a school administrator who is aware of your efforts to organize a chapter of Omega Phi Alpha on your campus.

Address *
Please provide contact information below for a school administrator who is aware of your efforts to organize a chapter of Omega Phi Alpha on your campus.

Phone *
Please provide contact information below for a school administrator who is aware of your efforts to organize a chapter of Omega Phi Alpha on your campus.

Email *
Please provide contact information below for a school administrator who is aware of your efforts to organize a chapter of Omega Phi Alpha on your campus.

Please explain your reasoning for requesting affiliation with Omega Phi Alpha on your campus. *
Please include 2-3 paragraphs.

Signatures *
By affixing our signatures to this document, we affirm that the information herein is true and complete to the best of our knowledge.