JULY 15-19, 2015 - Phi Beta Sigma Fraternity, Inc.

Transcription

Securing the
future of our
young men
of color!
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PHI BETA SIGMA FRATERNITY, INC.
CHAPTER
PLANNING TOOL KIT
JULY 15-19, 2015
www.phibetasigma1914.org
PHI BETA SIGMA FRATERNITY, INCORPORATED
INTERNATIONAL PRESIDENT
GREETINGS BROTHERS!
“There’s Something Special Going on in Phi Beta
Sigma Fraternity!” The celebration is still alive
as our Centennial year draws to a close. But the
continuation of the work remains the focus of
our future. Our Founding Fathers envisioned a
fraternity focused on improving the lives of the
communities we serve. If not us, then who?
I’m excited to join each of you, as Sigma Men from
every city and campus prepare to gather in the
Southwestern Region to experience “A New Way
to Conclave.” We’re transforming our conference
in order to transform lives. I encourage you to
make preparations today to be apart of this
groundbreaking convention.
I AM MY BROTHER’S KEEPER: DESTINATION LITTLE ROCK • 2015 CONCLAVE
When President Barack Obama sounded the
call with the White House initiative, My Brother’s
Keeper, Phi Beta Sigma responded in loud refrain
“I Am My Brother’s Keeper,” the theme and focus
of Conclave 2015, Destination: Little Rock.
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Securing the future of our young boys of color is the
primary focus of Conclave 2015. This convention
will feature I Am My Brother’s Keeper Forums, a
series of brain trusts focusing on empowering our
young men. Joining Phi Beta Sigma will be some
of the most acclaimed thought-leaders engaged
in relative topics facing today’s youth.
Mentoring is the way! I’m excited to devote
Conclave 2015 to enriching the conference
experience of our Sigma Beta Club program. I’m
enlisting all alumni chapters to make sure your
club members don’t miss this experience.
This is your Conclave 2015 Chapter Planning
Took Kit. It provides your chapter with all of the
necessary information and forms needed to fully
prepare for Conclave participation. You’ll find
valuable content on our host city, hotel and a dayby-day agenda.
Also included are the forms needed for proper
registration for the convention, competitions,
activities, citations and recognitions. Please review
the forms carefully and submit them timely
according to the deadline dates.
The General Board, Conclave Planning Team,
Headquarters Staff and Host Chapters are eagerly
working to assure that members and chapters will
enjoy a total new experience. You will leave this
conference transformed and ready to transform.
Honorable Brother Jonathan A. Mason, Sr.
International President
INTERNATIONAL EXECUTIVE DIRECTOR
GREETINGS CHAPTERS!
Make plans now to journey to the Southwestern
Region and experience “I Am My Brother’s
Keeper” and the southern hospitality of Little
Rock, Arkansas. The city of Little Rock is home to
Mu Beta Sigma Chapter, the first chapter in the
history of Phi Beta Sigma Fraternity to reach 200
members. Also readily waiting to serve, as your
hosts, are the brothers of Lambda Gamma Sigma
Chapter and Phi Chapter.
I encourage all chapter advisors and chapter
presidents to review the entire kit with your
executive boards or convention committees to
assure that each member is aware of submission
deadlines and registration timelines.
Please feel free to contact your international
headquarters with any questions or concerns
regarding your chapter’s registration.
There’s Something Special Going on in Phi Beta
Sigma Fraternity, Inc. and the excitement will
continue in Little Rock, Arkansas!
See you there!
Brother Daryl A. Anderson, Sr.
International Executive Director
To assist your chapter with total preparation, we’ve
prepared the Conclave 2015 Chapter Planning
Tool Kit. This booklet is provided to your chapter
with all of the tools and information needed to
enjoy a complete convention experience. In this
document are answers, processes and guidelines
to effectively complete and submit forms for every
component.
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City of Little Rock, Arkansas
I AM MY
BROTHER’S KEEPER:
DESTINATION LITTLE ROCK
Come on over to the Southwestern Region, where the city of Little Rock, Arkansas, will welcome you with hospitality.
As Arkansas’s capital city and cultural core, the greater Little Rock area will provide Sigma Brothers and guests with
a wealth of engaging experiences. In fact, Little Rock received numerous accolades, including being ranked #1 in
2013 by Kiplinger’s Personal Finance in its annual “10 Great Places to Live,” and being named one of “Five Secret
Foodie Cities” by Forbes Travel Guide. With so much to see and do, we are confident you will fall in love with Little
Rock.
Situated on the Arkansas River, Little Rock is home to a thriving New South culture that offers a vibrant nightlife,
big-time entertainment, world-class attractions and a booming dining scene with the best Arkansas restaurants
serving up dishes from all over the globe. The fact that the city is one of the top Arkansas vacation spots and among
America’s most affordable cities means you can have fun and keep your money in your pocket.
4
Little Rock has a big role in history, as it’s home to famed Central High School, the battleground in the struggle
for civil rights featuring 1957’s The Little Rock Nine, a group of African American students that desegregated the
school following the historic Brown v. Board of Education ruling in 1954.
Just a few city blocks away from the Little Rock Marriott, the host hotel for Conclave 2015, lies the William J. Clinton
Presidential Center & Park. Explore the city’s Riverfront Park, a 33-acre urban park located along the south bank of
the Arkansas River. The park is home to many great attractions and events. First Security Amphitheater, Arkansas’s
largest outdoor concert venue, offers scenic views of the river as a backdrop.
STATEHOUSE CONVENTION CENTER
Little Rock’s Statehouse Convention Center is located in the heart of
the downtown convention and entertainment district. It’s only a short walk
or trolley ride to a wide variety of restaurants, performing arts venues,
world-class attractions, and an assortment of outdoor entertainment
activities, all ready and waiting to be enjoyed, day or night.
The center is attached to the Little Rock Marriott and is only steps away
from a collection of hotels offering guests everything from historic charm
to the latest in modern convenience and luxury.
LITTLE ROCK MARRIOTT (PRIMARY HOTEL)
3 Statehouse Plaza
Little Rock, AR 72201
Phone: 501-906-4000
Experience a winning combination of elegance and comfort at the Little Rock Marriott. Phi Beta Sigma has chosen the
only full-service hotel in the state of Arkansas; their experienced staff is committed to making sure that your stay will
be memorable. The property’s 418 rooms and suites are smartly designed and filled with thoughtful amenities; enjoy
complimentary wireless Internet service, as well as a well-lit work area to help you stay productive. Relax in front of
your 42-inch flat-screen TV, or reserve one of the deluxe Club Level rooms, with views of the downtown skyline or
the Arkansas River. Other hotel amenities include Italian fare at Pancetta Regional Kitchen + Wine Bar and a modern
fitness center. Last but not least, the property is located in downtown Little Rock, which enables you to explore the
city with ease.
THE DOUBLETREE BY HILTON
DOWNTOWN LITTLE ROCK (SECONDARY HOTEL)
424 W. Markham Street
Little Rock, AR 72201
Phone: 866-460-7456
The Doubletree Little Rock is just steps away from The Little Rock Marriott. Make yourself at home in one of the 288
air-conditioned rooms featuring MP3 docking stations and LCD televisions. Complimentary wireless Internet access
keeps you connected, and satellite programming is available for your entertainment.
TRAVEL ARRANGEMENTS
You are encouraged to visit our Conclave Website at
www.phibetasigma1914.org for frequently updated travel discounts.
The Little Rock Marriott is connected to the Statehouse Convention Center, where Phi Beta Sigma will convene its
Plenary Sessions, Sigma Marketplace, Job Fair and other special events.
5
General Registration Information
Included in this Chapter Planning Tool Kit is vital information on the 2015 Conclave registration process. Please
note that some conference events and activities are not included in the registration fee. Entry into those events will
require the purchase of a ticket, if you qualify for admittance. Specifically, tickets to the Life Members’ Breakfast and
DSC Dinner are not included in the registration fee. Fraternity members seeking to participate in those events are
required to purchase individual tickets with this registration. No tickets will be sold onsite to these events. However,
individual tickets to other events will be sold onsite.
REGISTRATION MATERIALS
All Conclave materials will be available for pick-up at the registration site. Pre-registered Brothers and guests
MUST provide the 2015 Conclave Confirmation Letter and a government-issued photo ID to receive their Conclave
materials. Early Bird – VIP Registration will be available for elected and appointed General Board officers, DSC
members, Sapphire and Platinum Life Members, Past International Presidents, Golden Heritage Brothers,
and Brothers with special needs accomondation. Please postmark your registration form to the International
Corporate Headquarters by: June 15, 2015.
CONFIRMATION LETTER
Registered participants will receive their 2015 Conclave Confirmation Letters within 30 days of receipt of your
payment. The letters will be sent via United States Postal Service from the International Corporate Headquarters.
Those who register online will receive electronic confirmation letters. Please contact our International Corporate
Headquarters if your confirmation letter is not received within the 30 day time period.
6
SPECIAL NEEDS ATTENDEES
All Business Sessions will provide special seating for Brothers with special needs. Registered members requiring
assistance must indicate on their registration forms the nature of their special accomondation. This information is
needed in order for the Conclave Planning Team to work with the hotel to insure proper assistance will be provided.
REGISTRATION RATE INFORMATION
The 2015 Conclave Registration Rates are below. This information is also available on the international website.
Various deadlines have been established based on the registration rate. Payments postmarked or completed
online after June 15, 2015 will be processed at the “Late Registration” rate.
LATE REGISTRATION
JAN 10, 2015 – JUN 15, 2015 NO ON-SITE REGISTRATION
ALUMNI: $625 | COLLEGIATE: $475 | GUEST: $475
PAYMENT OPTIONS
The preferred method for payment of registration fees is the Blu Print Database System
(http://www.phibetasigma1914.org/membership/bluprint/.) Personal checks, cashier/bank checks, all major credit
cards, or money orders are acceptable forms of payments. All credit card payments require an additional fee
and may be completed online. PayPal is an added option for registering. Additionally, funds can be transferred
from your Phi Beta Sigma Federal Credit Union account for registration payments.
•
Personal checks are accepted from August 16, 2014 through March 15, 2015.
•
Credit cards, bank checks, and money orders are accepted from August 16, 2014 through the end of Conclave
2015.
•
No mail-in registrations are accepted after June 15, 2015, regardless of the form of payment.
5 MONTH PAYMENT OPTIONS
A 5 month payment plan is available to members during the Early Dove and Regular Registration periods only. The
payment plan is available by payments of check or money orders and mail-in only. On-line and call-in payments by
credit card are not available for this plan. You have five months from the date of your initial payment to complete
the total registration fee. Each payment is assessed a $5 processing fee.
REGISTRATION REFUND POLICY
Registration fees are eligible for a refund at a rate of 50%, provided written notification is submitted to and received
at Phi Beta Sigma’s International Corporate Headquarters with a postmark date no later than June 9, 2015.
VOTING INFORMATION
Conclave 2015 participants designated as the primary delegate and/or alternate delegate representing their
respective chapter and other qualified voting members, must provide official confirmation of their eligibility
status from the Corporate Headquarters. Each delegate must complete the Delegate Certification Section on the
Registration Form.
REGISTRATION TRANSFER POLICY
Registration funds are transferable from one financial member to another financial member. The policy also covers
one registered guest to another registered guest. Written and signed permission from the transferor to the
transferee is required for those transactions. A Brother may transfer his personal registration ONLY. The deadline
for the transferring of Conclave registration is June 9, 2015. Any unforeseen circumstances after this date will be
reviewed on a case-by-case basis.
7
Schedule-At-A-Glance
MONDAY, JULY 13, 2015
• REGISTRATION SET-UP (registration by region)
• HOTEL PRE-CON MEETING
TUESDAY, JULY 14, 2015
•ORIENTATION
9:00am – 10:00am
Marriott Ballroom
Marriott – Manning Room
10:00am – 12:00pm
Marriott
• COMMITTEE MEETINGS
2:00pm – 5:00pm
Marriott
6:00pm – 9:00pm
Marriott - Riverview Ballroom
• GENERAL BOARD MEETING
• GENERAL BOARD DINNER
• VOLUNTEER ORIENTATION
WEDNESDAY, JULY 15, 2015
• SIGMA OFFICE
• COLLEGIATE ADVISOR CERTIFICATION
• FIRST-TIME ATTENDEES ORIENTATION
12:00pm – 1:30pm
3:00pm – 5:00pm
7:00pm – 9:00pm
8:00am – 5:00pm
8:00am – 10:00am
8:00am – 10:00am
10:00am – 12:00pm
• I AM MY BROTHER’S KEEPER FORUMS 10:30am – 12:00pm
• DELEGATE CERTIFICATION AND REGISTRATION
• SIGMA MARKETPLACE
• LUNCH ON YOUR OWN
3:00pm – 5:00pm
Convention Center – Caddo, Osage & Rotunda
8
9:00am – 5:00pm
• “THERE’S SOMETHING SPECIAL GOING ON IN
PHI BETA SIGMA FRATERNITY, INC.” THE OPENING CEREMONY
• “THERE’S SOMETHING SPECIAL GOING ON” RECEPTION
• THE BARBERSHOP
THURSDAY, JULY 16, 2015
• REGISTRATION/DELEGATE CERTIFICATION/VOTE TOOL DISTRIBUTE
• SIGMA OFFICE
• BREAKFAST WITH THE CANDIDATES
• SIGMA MUSEUM & CHAPTER DISPLAYS
• REGIONAL CAUCUSES
• PLENARY SESSION I
10:00am – 5:00pm
12:00pm – 6:00pm
12:00pm – 1:00pm
6:30pm – 9:00pm
9:00pm – 11:00pm
11:00pm – 1:00am
6:00am – 5:00pm
8:00am – 5:00pm
8:00am – 10:00am
9:00am – 5:00pm
10:00am – 7:00pm
10:00am – 11:30am
10:00am – 11:30am
Marriott – Arkansas Ballroom
Marriott – Harris Drake Room
Convention Center – Quapaw Room
Marriott – Conway Room
Marriott – Grand Ballroom – Salon A
Marriott – Caddo, Osage & Rotunda
Marriott
Convention Center – Governors Hall 1
Convention Center – Governors Hall 2 & 3
Convention Center – Wally Allen Ballroom & Terrace
Marriott –Riverview Ballroom
Marriott
Marriott
12:00pm – 1:30pm
Convention Center – Wally Allen Ballroom
• PLENARY SESSION II
3:00pm – 6:00pm
• MISS INTERNATIONAL PHI BETA SIGMA PAGEANT
7:00pm – 9:00pm
• DINNER ON YOUR OWN
• LOCAL CHAPTERS’ WHITE PARTY
• THE BARBERSHOP
1:30pm – 3:00pm
6:00pm – 7:00pm
9:00pm – Until
10:00pm – 1:00pm
Marriott – Riverview Ballroom
• OMEGA & REDEDICATION CEREMONIES
• SIGMA OFFICE
• PBSFCU ANNUAL BREAKFAST MEETING
• LEGENDS ROUNDTABLE
• FOUNDERS’ & SBC AWARDS LUNCHEON/ORATORICAL CONTEST
• SIGMA MUSEUM & CHAPTER DISPLAYS
• PLENARY SESSION III
• DISTINGUISHED SERVICE CHAPTER DINNER (DSC only)
• DINNER ON YOUR OWN
• PBS INTERNATIONAL STEP SHOW COMPETITION & CONCERT
• NPHC NIGHT
• THE BARBERSHOP
SATURDAY, JULY 18, 2015
• LIFE MEMBERS’ BREAKFAST (Life Members Only)
• COMMITTEE MEETING A
• COMMITTEE MEETING B
• SIGMA OFFICE
7:00am – 8:30am
8:30am – 9:30am
Marriott – Ballroom – Salon C
8:00am – 5:00pm
9:00pm – 12:00pm
9:30am – 12:00pm
10:00am – 9:00pm
12:00pm – 2:00pm
12:00pm – 5:00pm
2:00pm – 3:30pm
6:30pm – 8:00pm
6:30pm – 7:30pm
8:00pm – 1:00am
10:00pm – Until
Marriott – Ballroom – Salon A & B
Marriott
First Security Amphitheater
Marriott – Ballroom – Salon C & Terrace
10:00pm – 1:00pm
Marriott – Riverview Ballroom
7:30am – 8:30am
Marriott – Ballroom – Salon C
7:00am – 9:00am
7:00am – 9:00am
8:00am – 1:00pm
Marriott – Hoffman Room
Marriott – Lafayette Room
• I AM MY BROTHER’S KEEPER JOB FAIR
9:00am – 5:00pm
Marriott – Ballroom A & B
9:00am – 6:00pm
• I AM MY BROTHER’S KEEPER SIGMA BUSINESS EXPO
• SIGMA MUSEUM
• PLENARY SESSION IV
• I AM MY BROTHER’S KEEPER YOUTH ACTIVITY
• IMAGE AWARDS BANQUET & GRAND ORCHID BALL
SUNDAY, JULY 19, 2015
• ECUMENICAL SERVICE
• POST GENERAL BOARD MEETING
WHAT TO WEAR
9:00am – 5:00pm
9:00am – 12:00pm
9:00am – 12:00pm
12:00pm – 1:00pm
1:30pm – 5:00pm
7:30pm – 1:00am
9:00am – 10:00am
10:00am – 11:00am
The Opening Ceremony/Plenary Session - Fraternity Blue Blazer or Dark Suit, White Shirt and Blue Tie
IAMBK Forums/Plenary Sessions - Business Suit
Omega & Rededication Ceremonies - Dark Suit, White Shirt and Blue Tie
International Step Show Competition - Paraphernalia
Image Awards Banquet & Grand Orchind Ball - Tuxedo or Dark Suit
Marriott – Ballroom A & B
Off Property
Marriott – Conway Room
Marriott – Hoffman Room
FRIDAY, JULY 17, 2015
9
LITTLE ROCK, ARKANSAS
JULY 15, 2015 - JULY 19, 2015
SOUVENIR JOURNAL ADS
FORM MUST BE POSTMARKED BY: MAY 21, 2015 RETURN COMPLETED FORM TO:
I Am My Brother’s Keeper: Destination Little Rock | Conclave 2015
Phi Beta Sigma Fraternity, Inc. | Corporate Headquarters
145 Kennedy Street, NW | Washington, DC 20011-5294
general information
Last NameFirst Name MI
Chapter Region
Address
City/State/ZipE-mail
Phone Day (
) Evening (
) Fax (
)
advertisement size
Full Page: (7” width x 10” depth Color)
$200.00
Full Page: (7” width x 10” depth B/W)
$125.00
Half Page: (7” width x 5” depth Color)
$150.00
Half Page: {7” width x 5” depth B/W)
$90.00
Quarter Page: (3.5” widthx 5” depth Color)
$100.00
Quarter Page: (3.5” width x 5” depth B/W)
$75.00
Total Advertising $ _______________________
Special Placement (10%)
& Production Charges to
Produce Camera Ready
Art an additional (10%)
JULY 15, 2015 - JULY 19, 2015
REGISTRATION FORM
general information
Name: ____________________________________________________________________________ Member # _________________________
Address: ____________________________________________________________________________________________________________
City: _______________________________________________________________________ State: ___________ Zip: ____________________
Phone: _________________________________________________________
Please check: q
Home q
Mobile (cell) q
Work
Email: ______________________________________________________________________________________________________________
Chapter: __________________________________________________________ Location: __________________________________________
q
Officer
q
Life Member
q
DSC Member
q
Delegate
q
Alternate Delegate q
Hearing Impaired
payment information
Payment Method Please check: q
Check q
Money Order q
Cashier’s Check q
Credit Card
Amount Paid $_____________ Please make check payable to: PHI BETA SIGMA FRATERNITY, INC.
PRINT ONLY
Cardholder Name: ______________________________________________________________________________________________________
Billing Address: _______________________________________________________________________________________________________
City: _________________________________________________________________ State: ________________ Zip: _____________________
CREDIT CARD TYPE Please check: q VISA q MASTERCARD q DISCOVER q AMERICAN EXPRESS
Credit Card # _____________________________________________________________________________ Exp. Date: __________________
Amount to charge $_______________________
I authorize Phi Beta Sigma Fraternity, Inc. to charge the agreed amount listed above to my credit card provided herein. I agree that I will pay for this purchase in accordance with the
issuing bank cardholder agreement.
Authorized Signature: ____________________________________________________________________ Date: __________________________
5 month payment options
The 5 Month Payment Plan is available for Early Dove & Regular Registration Rates.
The plan features an initial payment and 4 remaining monthly payments.
A $5 processing fee for each transaction will apply. Payment plans are mail-in only.
• DSC Members receive 50% Discount on Alumni Regular Registration Rate - $237.50
• For payment plan details, see PAYMENT OPTIONS on page 7 of Conclave 2015
Chapter Planning Tool Kit.
MAIL TO: Phi Beta Sigma Fraternity, Inc.
145 Kennedy St. NW | Washington, DC 20011
JULY 15, 2015 - JULY 19, 2015
SPONSORSHIP AGREEMENT
TOTAL SPONSORSHIP INVESTMENT
BEING PROVIDED = $
DEADLINE FOR ALL AGREEMENTS: MAY 13, 2013
contact information
Last Name:First Name: MI:
Chapter: Region:
Address:
City/State/Zip:
Phone Day: (
) Evening: (
E-mail:
) Fax: (
)
Website:
exhibitor/sponsorship opportunities
q
q
q
q
q
q
A. LANGSTON TAYLOR LEVEL $75,000
CHARLES I. BROWN LEVEL $50,000
LEONARD F. MORSE LEVEL$25,000
CHARTER $15,000
MY COMPANY PLANS TO INVEST AS AN EXHIBITOR ONLY$2,000
EVENT SPONSOR
q AFRICAN AMERICAN IMAGE AWARDS BANQUET $10,000
q GRAND ORCHID BALL $10,000
q PRESIDENT’S RECEPTION $10,000
q FOUNDERS AWARDS BREAKFAST$5,000
q BROTHERHOOD LUNCHEON$5,000
q INTERNATIONAL MISS PHI BETA SIGMA PAGEANT$5,000
q INTERNATIONAL STEP SHOW COMPETITION $5,000
souvenir journal
MY COMPANY WOULD LIKE AN ADVERTISEMENT
IN THE SOUVENIR JOURNAL AS FOLLOWS:
(AD SIZE BASED ON 8.5” X 11” BOOK)
q
q
q
q
q
q
q
INSIDE FRONT COVER$1,500
INSIDE BACK COVER$1,500
OUTSIDE BACK COVER$1,500
FULL PAGE COLOR $500
HALF PAGE COLOR$250
FULL PAGE B/W
$200
HALF PAGE B/W $100
sigma market place features
(1) 8 X 10 booth placement,
(2) line sign, draping,
(2) six foot tables covered and skirted,
(2) chairs, (1) wastebasket
I agree to include a sponsorship/advertisement in the 2015
Phi Beta Sigma Conclave Program Journal, and agree to
deliver to the PUBLISHER or its AGENT camera-ready copy
and/or sponsorship text. Advertising and Sponsorship for
which complete copy is NOT received by its deadline, will
not be entitled to the privilege of approval or revision or
refund. The PUBLISHER reserves the right to refuse any
advertismentor editorial deemed inappropriate.
The COMPANY REPRESENTATIVE agrees he/she has the
authority to execute this agreement on behalf of the
COMPANY and is bound by the terms of this agreement.
ALL RATES ARE NET TO PUBLISHER. NO CANCELLATIONS. PAYMENT
IN FULL IS REQUIRED TO RESERVE SPACE.
ALL CHECKS should be made payable to:
Return original signed application and fees to:
CONCLAVE 2015 CORPORATE SPONSORS
145 KENNEDY STREET, NW | WASHINGTON, DC 2011
TEL (202) 726-5434 | FAX (202) 882-1681
Company Representative Date
JULY 15, 2015 - JULY 19, 2015
CANDIDATE NOTIFICATION FORM
overview
This form is designed to provide the National Nominating Committee information about candidates for International Office. This information
will provide the Committee the opportunity to review resumes, program objectives and schedule interviews. This form will also be given to the
moderator of the CANDIDATES’ FORUM. Please attach a copy of your resume.
NOTE: The Nominating Committee will notify you of the date and time of your interview. Please plan your conference participation
accordingly. All candidates must have paid all financial fees and assessments to the Fraternity and their respective Chapters.
The elected officers are:
•
•
•
•
•
International President
International First Vice-President
International Second Vice-President
International Treasurer
International Director of Bigger and Better Business
•
•
•
•
•
International Director of Collegiate Affairs
International Director of Education
International Director of Social Action
International General Counsel
Collegiate Member-at-Large (Two positions)
Refer to your International Constitution regarding the function of each officer.
general information
Last NameFirst Name MI
Chapter Region
Address
City/State/ZipE-mail
Phone Day (
) Evening (
) Fax (
)
Current Chapter Member #
I am seeking the office of:
Print Name Signature Date
additional comments
JULY 15, 2015 - JULY 19, 2015
CHAPTER DELEGATE CERTIFICATION FORM
delegate information
Chapter State
Primary Delegate Member #
Phone E-mail
Alternate Delegate Member #
Phone E-mail
president / treasurer information
Chapter President Member #
Chapter President’s E-mail
Chapter Treasurer Member #
Chapter Treasurer’s E-mail
NOTE: Your delegate and your alternate must be financial in order to participate in the conference and vote on behalf of
your chapter. Likewise, your chapter tax must be paid in order for your chapter to have any representation. FAILURE IN ANY
OF THESE REQUIREMENTS WILL RESULT IN THE REFUSAL TO SEAT YOUR DELEGATE AND/OR ALTERNATE ON THE
CONFERENCE FLOOR.
DO NOT WRITE BELOW THIS LINE
Financial
Non-Financial
AlternateState
Alternate Chapter
Chapter Tax # of Financial Members
Date Received
Confirmed By
additional comments
JULY 15, 2015 - JULY 19, 2015
CITATION FOR THE OMEGA CHAPTER
in honor of
Brother State
Cause of Death Date of Passing
Place of Birth Date of Birth
Current Chapter Initiating Chapter
beloved family member
Next of Kin Relationship
Address
City/State/Zip
submitted by
Citation Submitted By
Address
City/State/Zip
E-mail
JULY 15, 2015 - JULY 19, 2015
GRADUATING SENIOR RECOGNITION FORM
general
Chapter State
School Name
NOTE: Include any Brother who has graduated since the last International Conclave (July 2013).
graduating seniors
Brother
Address City/State/Zip
E-mail
Degree/Department Major/Minor
Brother
E-mail
Brother
E-mail
Brother
E-mail
Brother
E-mail
JULY 15, 2015 - JULY 19, 2015
MILESTONE INFORMATION FORM
general information
Any Brother who celebrates The Anniversary of 25, 50 or 75 Years of Service in the fraternity in the year 2015 should complete this form.
Last Name First Name MI
Chapter Initiated Initiation Date
Current Chapter Member #
Address
City/State/Zip E-mail
Phone Day (
) Evening (
)
Fax (
)
Present Occupation
Print Name Signature Date
JULY 15, 2015 - JULY 19, 2015
APPLICATION FOR THE COLLEGIATE CHAPTER
HIGHEST GRADE POINT AVERAGE AWARD
Date
(Office use only)
Please type all information. The essay should be thoughtfully and clearly written, but succinct. The application will be rated on appearance,
verifiability of information, clarity, and evidence of achievements. Incomplete applications will not be considered.
college / university and chapter information
College/University
Chapter Name
Chapter President Email
Chapter President Telephone Contact (
)
Chapter Advisor Chapter Advisor’s Email
Name of Sponsoring Alumni Chapter
chapter honors / awards
membership information
Name:
Member #
GPA:
Name:
Member #
GPA:
Name:
Member #
GPA:
Name:
Member #
GPA:
Name:
Member #
GPA:
Name:
Member #
GPA:
Name:
Member #
GPA:
Name:
Member #
GPA:
Name:
Member #
GPA:
Name:
Member #
GPA:
Note: Attach additional sheets if necessary.
Official Transcript for each brother is required (Certified by Registrar) verifying G.P.A and Classification
**All applicants must be a financial member of Phi Beta Sigma Fraternity with their local collegiate chapter and currently enrolled as an undergraduate student at the named college/
university above. All courses listed on member’s transcripts shall be approved baccalaureate curriculum by the state’s Board of Regents/Trustees. Only four and five year baccalaureate
programs are acceptable.
JULY 15, 2015 - JULY 19, 2015
EMMITT SMITH ATHLETIC
ACHIEVEMENT AWARD APPLICATION
Date
(Office use only)
personal information
Name: Member #
School Address: Permanent Address:
City: State: Zip:
Email Address:
school / professional information
College/University: Region:
G.P.A. Major/Minor: Classification:
Sport/Campus/Community Activities: (Include: All American Status if Applicable, Lettered, Leadership Positions, honors, and awards) Please use additional sheets if necessary
fraternal information
Chapter:
Fraternal Activities: (Include: offices held, honors, awards)
application requirements
(a) Official Transcript or letter (Certified by Registrar)
verifying G.P.A and Classification*
(b) Two (2) letters of recommendation**
(1) Head Coach or Athletic Director (College Letterhead)
(2) Professor or Academic Advisor (Letterhead)
(c) Resume
(d) List involvement with National Programs and Special Events
(e) Essay including career ambitions, goals and explain why you should be awarded this special recognition
*All applicants must be a financial member of Phi Beta Sigma Fraternity and currently enrolled as an undergraduate (5 year programs acceptable) or in a graduate/professional program with current
athletic eligibility. Minimum G.P.A 2.5/4.0 or equivalent.
**All Brothers can provide an additional letter of recommendation from a Chapter advisor or Alumni Chapter.
JULY 15, 2015 - JULY 19, 2015
THE ALAIN LEROY LOCKE SCHOLAR
HONORS CHAPTER APPLICATION
Date
(Office use only)
personal information
Name: Member #
School Address: Permanent Address:
City: State: Zip:
Email Address:
school / professional information
College/University: Region:
G.P.A. Major/Minor: Classification:
Campus/Community Activities: (Include: offices held, honors, and awards) Please use additional sheets if necessary
fraternal information
Chapter:
Fraternal Activities: (Include: offices held, honors, awards) Please use additional sheets if necessary
application requirements
(a) Official Transcript or letter (Certified by Registrar)
verifying G.P.A and Classification*
(b) Two (2) letters of recommendation**
(1) Personal source
(2) Institution source (College letterhead)
(c) Resume
(d) List any scholarship(s) received and other academic awards
(e) List involvement wtih national programs and special events
(f) Essay including career ambitions/ goals and an explanation of why you should be awarded the Achievement Award
(g) Picture (Headshot)
*All applicants must be a financial member of Phi Beta Sigma Fraternity and currently enrolled as an undergraduate. Minimum G.P.A 3.0/4.0 or equivalent.
**Institutional recommendations can come from a teacher/professor or an academic advisor.
JULY 15, 2015 - JULY 19, 2015
CHAPTER PLANNING KIT | CONCLAVE 2015
INTERNATIONAL STEP SHOW
COMPETITION
QUALIFICATIONS FORM MUST BE POSTMARKED BY: APRIL 30, 2015 RETURN COMPLETED FORM TO:
1. Each participating brother must be financial (national, regional and chapter status).
2. Each participating brother must be a member of the performing chapter(s).
RULES 1. 2.
Each chapter wishing to participate for cash prizes must return this form by the deadline.
Points will be deducted for profanity. Vulgarity, including sexual overtones and images of sexual acts will not be tolerated and any such displays will result in an immediate termination
of your performance and you will be disqualified.
3. The time limit for the show is 12 minutes including the entrance and the exit. Performances exceeding 12 minutes will be disqualified.
4. The performance order will be determined by lottery drawing.
DEADLINE June 9, 2015 — To be eligible for cash prizes, chapters must register by the deadline.
First Place: $2,000.00 Scholarship
Second Place: $1,000.00 Scholarship
Third Place:
$ 500.00 Scholarship
JUDGING CRITERIA Creativity/Originality
25 Points
Showmanship
25 Points
Dress/Appearance
25 Points
Transition/Synchronization
25 Points
PAGE 1 OF 2
(Continue on back)
JULY 15, 2015 - JULY 19, 2015
INTERNATIONAL STEP SHOW
COMPETITION
chapter information
Note: Only one chapter from each region will be entered into the competition at the International Conclave and that chapter must be approved
by the regional director.
Chapter State
Contact Person Phone Day (
)
E-mail
stepshow contestants
NUMBER OF CONTESTANTS
Include a list of Brothers and their fraternity card numbers.
NAME Member #
NAME Member #
NAME Member #
NAME Member #
NAME Member #
PAGE 2 OF 2
JULY 15, 2015 - JULY 19, 2015
INTERNATIONAL CONSTITUTION
CHANGE REQUEST FORM (Retain a copy for chapter files)
I/We, , of the
Region of Phi Beta Sigma Fraternity, Inc., wish to amend the International Constitution and By-Laws by:
SELECT ONE PER FORM
Inserting “certain” words in a “specific” place within the “existing” text.
Deleting “certain” words in a “specific” place within the “existing” text.
Deleting “certain” words in a “specific” place within the “existing” text and in place inserting “certain new words”.
Inserting a new paragraph (which does not now exist) between two existing paragraphs with the subsequent necessary renumbering.
Deleting existing paragraph with the subsequent necessary renumbering.
Substituting an already existing paragraph with an entirely new paragraph.
Present Wording in CONSTITUTION Paragraph
; Subsection or
states the following:
PAGE 1 OF 2
(Continue on back)
; Article, ; Section;
JULY 15, 2015 - JULY 19, 2015
INTERNATIONAL CONSTITUTION
CHANGE REQUEST FORM (Retain a copy for chapter files)
stated proposed wording
indicate why amendment is necessary:
Requestor’s Name
Requestor’s E-Mail
Chapter President
Member #
PAGE 2 OF 2
JULY 15, 2015 - JULY 19, 2015
RESOLUTION FORM
CHAPTER PLANNING KIT | CONCLAVE 2015
(Attach additional sheets, if necessary)
FORM MUST BE POSTMARKED BY: APRIL 30, 2015 RETURN COMPLETED FORM TO:
WHEREAS,
AND WHEREAS,
AND WHEREAS,
AND WHEREAS,
THEREFORE BE IT RESOLVED,
Chapter Date
Chapter President or Initiating Brother Member #
(Retain a copy for chapter files)

JULY 15-19, 2015 - Phi Beta Sigma Fraternity, Inc.

Transcription

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