Recruitment Verification Form

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Fairmont State University
Office of Student Activities & Greek Life
FERPA Academic Release Form


Please read the following carefully.

As a student at Fairmont State Univeristy and a prospective or current member of a Greek Organization, I hereby consent to the release of the following information in the manner indicated below pursuant to the Family Educational Rights and Privacy Act of 1974 (“FERPA”) (20 U.S.C. § 1232g; 34 C.F.R. Part 99):

Records to be disclosed: Semester grade point average, cumulative grade point average, semester hours/credits enrolled, permanent address and phone number, alert slips, suspension, or academic probation standing.

Parties to whom the records may be disclosed: Assistant Director of Student Life, Organization/Chapter President, Organization/Chapter Advisor, Recruitment Chair/New Member Educator, Academic Chair, Honorary Societies, (Inter) National Headquarters Staff.

Purpose of Disclosure: For use in scholarship and general statistics, educational programming, award recognition, and verification of minimum academic standards and college enrollment.

Length of Disclosure: This authorization shall remain in effect until I leave Fairmont State University unless earlier revoked by me, in writing and delivered to the Office of Residential and Student Life.

By submitting this form, I declare that all inforamtion given is correct and that I am aware of the rights granted to me by the Family Educational Rights and Privacy Act of 1974 and permit the Office of Residential & Student Life at Fairmont State University to release my education records to the identified individuals previously stated. I understand that this waiver will be in effect until I leave Fairmont State Univeristy.


No student shall, individually or by joining with one or more other persons, engage in any act of hazing involving another member of the institutional community.

Hazing may be defined as follows: to subject to cruel horseplay, to harass or punish by the imposition of disagreeable tasks, to frighten, scold, beaten, or annoy by playing abusive tricks upon an individual.

Fairmont State University prohibits any action which subjects a new member, initiate, or member of a student organization to activities which are personally demeaning or involve a substantial risk of physical injury. This includes both organized rites of initiations and informal activities.

Hazing may also include, but is not limited to any brutality such as: paddling; whipping; forced calisthenics; exposure to the elements; forced consumption of any food, liquor, or other substance; or any other forced physical activity which could adversely affect the physical health or safety of the individual; and shall include any activity which would subject the individual to extreme mental stress, such as sleep deprivation, forced exclusion from a social contract, forced conduct which could result in extreme embarrassment or adversely affect the mental health or dignity of the individual. Students involved in hazing activities are subject to institutional disciplinary action.

By submitting this form, I acknowledge that I have been advised of the Fairmont State University Hazing Policy and am aware that if at any time during my new member period that I feel I am being hazed in any manner I may contact the Coordinator of Student Activiites & Greek Life for help and support.