Tau Kappa Epsilon International Fraternity
Theta Phi Chapter at The University of Wisconsin La Crosse
1325 State Street
La Crosse, WI 54601
Promissory Note and Terms of Payment
______, 20______
I, ______, shall make payments to the Theta Phi Chapter of Tau
Kappa Epsilon International Fraternity. These payments are to be made payable to “Tau Kappa Epsilon – Theta Phi” and are for social and active membership dues, Fraternal Insurance/Liability Insurance, and additional fees as levied within the guidelines of Theta Phi Chapter Bylaws and the Black Book of the Tau Kappa Epsilon International Fraternity.
The total value of these payments is for
______dollars. The payment dates and amounts are illustrated below. If I should fail to make any one (1) payment by the corresponding dates below, I understand my privileges, as an active member of Tau Kappa Epsilon Fraternity will be immediately suspended pending payment. If I should fail to make any two (2) payments by corresponding dates indicated below or still have any of the principle of this note due ninety (90) days after the date of this note as listed above, I understand that the full unpaid amount as promised on this note will become immediately due and Tau Kappa Epsilon may initiate the process of removing me from the fraternity as prescribed by the Black Book of Tau Kappa Epsilon International Fraternity. In addition, I understand that if I am removed from the Fraternity for failure to keep within the guidelines of this note, I am not absolved of my responsibilities for the debts I have incurred.
Further, I understand that the Theta Phi Chapter of Tau Kappa Epsilon, its members, Board of Advisors (in whole or in part), Chapter Advisor, employee, or any other written designee of the Chapter or Board of Advisors may initiate a collection process including, but not limited to, the use of a legal proceeding and or collection agencies if I should fail to make two (2) consecutive payments by the dates listed below if I still have any principle remaining on this note ninety (90) days after the date of this note as listed above. In addition, I understand that if such means must be used in the collection of this note, any and all fees,, assessments, penalties, and legal expenses will be solely my responsibility.
If I have any questions regarding this contract, I understand I am to contact the current Chapter President or Treasurer.
I also understand that I am signing a legally binding promissory note and payment contract. In addition, I understand and agree this agreement is necessary, insofar as to maintain the financial stability and integrity of the Theta Phi Chapter of Tau Kappa Epsilon. Finally, as agreed to by myself and the Chapter Crysophylos (treasurer), I will adhere to the following payment structure.
Amount of payment (Hand written followed by $x.xx)Date DueCrysophylos Initials
1. ____/____/______
2.____/____/______
3.____/____/______
4.____/____/______
5.____/____/______
6.____/____/______
7.____/____/______
Signed and Dated:______/____/____
Print Name: ______
Witnessed and Dated: ______/____/____
Print Name: ______