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FORM 0064N – Hearing Certification
HEARING CERTIFICATION
Check appropriate line(s)
_____ I was aware of the hearing held by (Chapter/colony name) Chapterat (location of hearing) on (date) at (time) regarding (charges) chargesagainst me.
_____ I chose not to attend.
_____ I was unaware of the expulsion hearing on (date).
Date ________________________________________________
Signature of Charged Member
Delta Sigma Phi Headquarters, 2960 N. Meridian Street, Indianapolis, IN 46208 | [email protected]