This form serves as a way for the Office of Student Life to track changes in fraternity/sorority membership at UCA. If a member drops or is removed by the organization, this form must be completed or that individual will remain on the roster. The form should
be filled out if one or more of the following things take place:
- New Member drops on their own or is removed from the organization;
- Active Member drops on their own;
- Active Member is removed from organization (locally or nationally); and/or
- A member's status changes to become no longer active (such as graduating or transferring).
This form can be filled out by the individual member or a representative of the organization.
This form should be submitted within ONE WEEK of an individual leaving the chapter.
If you have any questions, please contact the Office of Student Life at
At the end of this form you will add the UCA email address for the organization president. This individual will be notified of the form submission.
This form only changes the roster housed in the UCA Office of Student Life. Please contact your (inter)national headquarters regarding paperwork for your (inter)national roster.