Name: Address: City: State, Zip: Collegiate Chapter: Initiation Date: Phone: Email: Birthday: Please note the committees you are interested in: Holiday Party Founders' Day Philanthropy Please note the events/activities you are interested in: Holiday Party Founders' Day Philanthropy Brunch Book Club Ronald McDonald House Pool Party Educational/Motivational Speakers Arts & Crafts Wine Tasting Movie Days Picnic/Cook-out Other: Comments/Questions

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