Membership Status Change Form

This form is to be used for any members of your Greek Organization who are no longer active with the chapter, due to graduation, withdrawal from the University, disaffiliation, or inactive status. Disaffiliation involves students who have decided to terminate their collegiate affiliation or have been removed from active membership, and no longer have any ties to the organization.

Inactive status is taken by members who have elected to become inactive in your organization. They will have no participation in chapter activities, no longer pay dues depending on Chapter by-laws, but still have the right to wear their Greek letters.

Chapter Name (ex: Pi Kappa Alpha)

Member's First Name

Member's Last Name

Member's UNCW Email

Reason for leaving chapter

Explanation for Disaffiliation or Inactive Status (If you are leaving UNCW, please enter N/A.)