Graduate MIP Manual (April 2019)
Section IV Information Session Attendance Sheet
Chapter: ______________________________ Date of Information Session: _________________
Region: ______________________________ Location: _____________________________
Name (Printed) Signature
We confirm that everyone signing this sheet attended the entire Information Session.
_______________________________ ______________________________ ___________
Membership Chairman (Print Name) Signature
_______________________________ ______________________________ ___________
Basileus (Print Name) Signature Date
Duplicate and have Information Session attendees sign after completing the Information Session.
Send signed original to Corporate Office with candidate materials, a scanned copy to the Regional Director, and retain a copy for
chapter files.