Acknowledgement of Reporting Obligation

Of Archons, Appointed Volunteer Leaders, and Staff Members of The Fraternity of Phi Gamma Delta

I, ____________________________________ (Name),

as ____________________________________ (Title),

of the Fraternity of Phi Gamma Delta, Inc. ("Phi Gamma Delta"), acknowledge that to the extent that I become aware of any action(s) or inaction(s) by brothers/members that violate(s) the Constitution, Bylaws and/or the Risk Management Policy of Phi Gamma Delta, I have the duty to report what I know to the Executive Director, the Archon President or the General Counsel of the Fraternity. Such reportable action(s) and inaction(s) include(s) the violation of any local, state, professional and/or federal law.