Exemplar Membership Agreement

Voices Against Cruelty, Hatred and Intolerance (VACHI)

Membership Agreement

[Insert Name of School]

I, ____________________________, support VACHI’s mission to spread awareness of the consequences of hate-motivated behavior to [insert name of school] students, staff, and parents. As a member of VACHI, I will fully uphold its bylaws and will uphold the following mission statement:


“To educate, students, parents, and teachers about the consequences of hate- related behavior with the goal of reducing/ eliminating it in the future.”


As a member of VACHI, I promise not to engage in any hate motivated behavior. Hate- motivated behavior is any act or statement motivated by hostility towards a victim’s actual or perceived race, ethnicity, national origin, immigrant status, gender, sexual orientation, religious belief, age, disability, or any other physical or cultural characteristic. I shall encourage my classmates to also refrain from such behavior. Should I observe any violations, I am obligated to take at least one of the following actions:


a.       Talk personally to the violator and let them know that their actions demonstrate hate motivated behavior. I will remind them of the consequences that could result if they had been caught by a teacher or administrator.


b.      If the action resulted in physical or emotional harm to another student, I am obligated to report the violator to a teacher, administrator, or School counselor.


As a member of VACHI, I hereby authorize [insert name of school] Administration to report any disciplinary action taken against me for hate motivated behavior to VACHI’s executive committee.



_____________________________________________ _______________

Signature Date


Student printed name ___________________________ Class of: ________


Student E-mail:_______________________ Parent email: ________________________


Student Cell Phone: ___________________ Home Phone: ________________________

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