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R1C1W12,R2C1W6,R2C2W6,R3C1W12
Membership Reclamation Form
Your Information
Full Name
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Date of Birth
April 2024
April 2024
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Your Address Information
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Contact Information
Email
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Mobile Phone
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Membership Information
Initiated Chapter
(None)
Alpha
Alpha Alpha
Alpha Alpha Omega
Alpha Beta
Alpha Beta Omega
Alpha Beta Omega
Alpha Chi
Alpha Chi Omega
Alpha Delta
Alpha Delta Omega
Alpha Epsilon
Alpha Epsilon Omega
Alpha Eta
Alpha Eta Omega
Alpha Gamma
Alpha Gamma Omega
Alpha Iota
Alpha Iota Omega
Alpha Kappa
Alpha Kappa Omega
Alpha Lambda
Alpha Lambda Omega
Alpha Mu
Alpha Mu Omega
Alpha Nu
Alpha Nu Omega
Alpha Omega
Alpha Omega Omega
Alpha Omicron
Alpha Omicron Omega
Alpha Phi
Alpha Phi Omega
Alpha Pi
Alpha Pi Omega
Alpha Psi
Alpha Psi Omega
Alpha Rho
Alpha Rho Omega
Alpha Sigma
Alpha Sigma Omega
Alpha Tau
Alpha Tau Omega
Alpha Theta
Alpha Theta Omega
Alpha Upsilon
Alpha Upsilon Omega
Alpha Xi
Alpha Xi Omega
Alpha Zeta
Alpha Zeta Omega
Beta
Beta Alpha
Beta Alpha Omega
Beta Beta
Beta Beta Omega
Beta Chi
Beta Chi Omega
Beta Delta
Beta Delta Omega
Beta Epsilon
Beta Epsilon Omega
Beta Eta
Beta Eta Omega
Beta Gamma
Beta Gamma Omega
Beta Iota
Beta Iota Omega
Beta Kappa
Beta Kappa Omega
Beta Lambda
Beta Lambda Omega
Beta Mu
Beta Mu
Beta Mu Omega
Beta Nu
Beta Nu Omega
Beta Omega
Beta Omega Omega
Beta Omicron
Beta Omicron Omega
Beta Phi
Beta Phi Omega
Beta Pi
Beta Pi Omega
Beta Psi
Beta Psi Omega
Beta Rho
Beta Rho Omega
Beta Sigma
Beta Sigma Omega
Beta Tau
Beta Tau Omega
Beta Theta
Beta Theta Omega
Beta Upsilon
Beta Upsilon Omega
Beta Xi
Beta Xi Omega
Beta Zeta
Beta Zeta Omega
Chi
Chi Omega
Delta
Delta Alpha
Delta Alpha Omega
Delta Beta
Delta Beta Omega
Delta Chi
Delta Delta
Delta Delta Omega
Delta Epsilon
Delta Epsilon Omega
Delta Eta
Delta Eta Omega
Delta Gamma
Delta Gamma Omega
Delta Iota
Delta Iota Omega
Delta Kappa
Delta Kappa Omega
Delta Lambda
Delta Lambda Omega
Delta Mu
Delta Mu Omega
Delta Nu
Delta Nu Omega
Delta Omega
Delta Omicron
Delta Omicron Omega
Delta Phi
Delta Pi
Delta Psi
Delta Rho
Delta Sigma
Delta Tau
Delta Theta
Delta Theta Omega
Delta Upsilon
Delta Xi
Delta Xi Omega
Delta Zeta
Delta Zeta Omega
Epsilon
Epsilon Alpha
Epsilon Beta
Epsilon Chi
Epsilon Delta
Epsilon Epsilon
Epsilon Eta
Epsilon Gamma
Epsilon Iota
Epsilon Kappa
Epsilon Lambda
Epsilon Mu
Epsilon Nu
Epsilon Omega
Epsilon Omicron
Epsilon Phi
Epsilon Pi
Epsilon Psi
Epsilon Rho
Epsilon Sigma
Epsilon Tau
Epsilon Theta
Epsilon Upsilon
Epsilon Xi
Epsilon Zeta
Eta
Eta Alpha
Eta Beta
Eta Chi
Eta Delta
Eta Epsilon
Eta Eta
Eta Gamma
Eta Iota
Eta Kappa
Eta Lambda
Eta Mu
Eta Nu
Eta Omega
Eta Omicron
Eta Phi
Eta Pi
Eta Psi
Eta Rho
Eta Sigma
Eta Tau
Eta Theta
Eta Upsilon
Eta Xi
Eta Zeta
Gamma
Gamma Alpha
Gamma Alpha Omega
Gamma Beta
Gamma Beta Omega
Gamma Chi
Gamma Chi Omega
Gamma Delta
Gamma Delta Omega
Gamma Epsilon
Gamma Epsilon Omega
Gamma Eta
Gamma Eta Omega
Gamma Gamma
Gamma Gamma Omega
Gamma Iota
Gamma Iota Omega
Gamma Kappa
Gamma Kappa Omega
Gamma Lambda
Gamma Lambda Omega
Gamma Mu
Gamma Mu Omega
Gamma Nu
Gamma Nu Omega
Gamma Omega
Gamma Omega Omega
Gamma Omicron
Gamma Omicron Omega
Gamma Phi
Gamma Phi Omega
Gamma Pi
Gamma Pi Omega
Gamma Psi
Gamma Psi Omega
Gamma Rho
Gamma Rho Omega
Gamma Sigma
Gamma Sigma Omega
Gamma Tau
Gamma Tau Omega
Gamma Theta
Gamma Theta Omega
Gamma Upsilon
Gamma Upsilon Omega
Gamma Xi
Gamma Xi Omega
Gamma Zeta
Gamma Zeta Omega
Iota
Iota Alpha
Iota Beta
Iota Delta
Iota Epsilon
Iota Gamma
Iota Omega
Kappa
Kappa Omega
Lambda
Lambda Omega
Mu
Mu Omega
Nu
Nu Omega
Omega
Omicron
Omicron Omega
Phi
Phi Omega
Pi
Pi Omega
Psi
Psi Omega
Rho
Rho Omega
Sigma
Sigma Omega
Tau
Tau Omega
Theta
Theta Alpha
Theta Beta
Theta Chi
Theta Delta
Theta Epsilon
Theta Eta
Theta Gamma
Theta Iota
Theta Mu
Theta Nu
Theta Omega
Theta Omicron
Theta Phi
Theta Pi
Theta Psi
Theta Rho
Theta Sigma
Theta Tau
Theta Theta
Theta Upsilon
Theta Xi
Theta Zeta
Unassigned Chapter
Upsilon
Upsilon Omega
Xi
Xi Omega
Zeta
Zeta Alpha
Zeta Beta
Zeta Chi
Zeta Delta
Zeta Epsilon
Zeta Eta
Zeta Gamma
Zeta Iota
Zeta Kappa
Zeta Lambda
Zeta Mu
Zeta Nu
Zeta Omega
Zeta Omicron
Zeta Phi
Zeta Pi
Zeta Psi
Zeta Rho
Zeta Sigma
Zeta Tau
Zeta Theta
Zeta Upsilon
Zeta Xi
Zeta Zeta
Required Field
Initiation Date
April 2024
April 2024
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Time picker
Time Picker
12:00 AM
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2:00 AM
3:00 AM
4:00 AM
5:00 AM
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11:00 AM
12:00 PM
1:00 PM
2:00 PM
3:00 PM
4:00 PM
5:00 PM
6:00 PM
7:00 PM
8:00 PM
9:00 PM
10:00 PM
11:00 PM
Required Field
Current Chapter
(None)
Alpha
Alpha Alpha
Alpha Alpha Omega
Alpha Beta
Alpha Beta Omega
Alpha Beta Omega
Alpha Chi
Alpha Chi Omega
Alpha Delta
Alpha Delta Omega
Alpha Epsilon
Alpha Epsilon Omega
Alpha Eta
Alpha Eta Omega
Alpha Gamma
Alpha Gamma Omega
Alpha Iota
Alpha Iota Omega
Alpha Kappa
Alpha Kappa Omega
Alpha Lambda
Alpha Lambda Omega
Alpha Mu
Alpha Mu Omega
Alpha Nu
Alpha Nu Omega
Alpha Omega
Alpha Omega Omega
Alpha Omicron
Alpha Omicron Omega
Alpha Phi
Alpha Phi Omega
Alpha Pi
Alpha Pi Omega
Alpha Psi
Alpha Psi Omega
Alpha Rho
Alpha Rho Omega
Alpha Sigma
Alpha Sigma Omega
Alpha Tau
Alpha Tau Omega
Alpha Theta
Alpha Theta Omega
Alpha Upsilon
Alpha Upsilon Omega
Alpha Xi
Alpha Xi Omega
Alpha Zeta
Alpha Zeta Omega
Beta
Beta Alpha
Beta Alpha Omega
Beta Beta
Beta Beta Omega
Beta Chi
Beta Chi Omega
Beta Delta
Beta Delta Omega
Beta Epsilon
Beta Epsilon Omega
Beta Eta
Beta Eta Omega
Beta Gamma
Beta Gamma Omega
Beta Iota
Beta Iota Omega
Beta Kappa
Beta Kappa Omega
Beta Lambda
Beta Lambda Omega
Beta Mu
Beta Mu
Beta Mu Omega
Beta Nu
Beta Nu Omega
Beta Omega
Beta Omega Omega
Beta Omicron
Beta Omicron Omega
Beta Phi
Beta Phi Omega
Beta Pi
Beta Pi Omega
Beta Psi
Beta Psi Omega
Beta Rho
Beta Rho Omega
Beta Sigma
Beta Sigma Omega
Beta Tau
Beta Tau Omega
Beta Theta
Beta Theta Omega
Beta Upsilon
Beta Upsilon Omega
Beta Xi
Beta Xi Omega
Beta Zeta
Beta Zeta Omega
Chi
Chi Omega
Delta
Delta Alpha
Delta Alpha Omega
Delta Beta
Delta Beta Omega
Delta Chi
Delta Delta
Delta Delta Omega
Delta Epsilon
Delta Epsilon Omega
Delta Eta
Delta Eta Omega
Delta Gamma
Delta Gamma Omega
Delta Iota
Delta Iota Omega
Delta Kappa
Delta Kappa Omega
Delta Lambda
Delta Lambda Omega
Delta Mu
Delta Mu Omega
Delta Nu
Delta Nu Omega
Delta Omega
Delta Omicron
Delta Omicron Omega
Delta Phi
Delta Pi
Delta Psi
Delta Rho
Delta Sigma
Delta Tau
Delta Theta
Delta Theta Omega
Delta Upsilon
Delta Xi
Delta Xi Omega
Delta Zeta
Delta Zeta Omega
Epsilon
Epsilon Alpha
Epsilon Beta
Epsilon Chi
Epsilon Delta
Epsilon Epsilon
Epsilon Eta
Epsilon Gamma
Epsilon Iota
Epsilon Kappa
Epsilon Lambda
Epsilon Mu
Epsilon Nu
Epsilon Omega
Epsilon Omicron
Epsilon Phi
Epsilon Pi
Epsilon Psi
Epsilon Rho
Epsilon Sigma
Epsilon Tau
Epsilon Theta
Epsilon Upsilon
Epsilon Xi
Epsilon Zeta
Eta
Eta Alpha
Eta Beta
Eta Chi
Eta Delta
Eta Epsilon
Eta Eta
Eta Gamma
Eta Iota
Eta Kappa
Eta Lambda
Eta Mu
Eta Nu
Eta Omega
Eta Omicron
Eta Phi
Eta Pi
Eta Psi
Eta Rho
Eta Sigma
Eta Tau
Eta Theta
Eta Upsilon
Eta Xi
Eta Zeta
Gamma
Gamma Alpha
Gamma Alpha Omega
Gamma Beta
Gamma Beta Omega
Gamma Chi
Gamma Chi Omega
Gamma Delta
Gamma Delta Omega
Gamma Epsilon
Gamma Epsilon Omega
Gamma Eta
Gamma Eta Omega
Gamma Gamma
Gamma Gamma Omega
Gamma Iota
Gamma Iota Omega
Gamma Kappa
Gamma Kappa Omega
Gamma Lambda
Gamma Lambda Omega
Gamma Mu
Gamma Mu Omega
Gamma Nu
Gamma Nu Omega
Gamma Omega
Gamma Omega Omega
Gamma Omicron
Gamma Omicron Omega
Gamma Phi
Gamma Phi Omega
Gamma Pi
Gamma Pi Omega
Gamma Psi
Gamma Psi Omega
Gamma Rho
Gamma Rho Omega
Gamma Sigma
Gamma Sigma Omega
Gamma Tau
Gamma Tau Omega
Gamma Theta
Gamma Theta Omega
Gamma Upsilon
Gamma Upsilon Omega
Gamma Xi
Gamma Xi Omega
Gamma Zeta
Gamma Zeta Omega
Iota
Iota Alpha
Iota Beta
Iota Delta
Iota Epsilon
Iota Gamma
Iota Omega
Kappa
Kappa Omega
Lambda
Lambda Omega
Mu
Mu Omega
Nu
Nu Omega
Omega
Omicron
Omicron Omega
Phi
Phi Omega
Pi
Pi Omega
Psi
Psi Omega
Rho
Rho Omega
Sigma
Sigma Omega
Tau
Tau Omega
Theta
Theta Alpha
Theta Beta
Theta Chi
Theta Delta
Theta Epsilon
Theta Eta
Theta Gamma
Theta Iota
Theta Mu
Theta Nu
Theta Omega
Theta Omicron
Theta Phi
Theta Pi
Theta Psi
Theta Rho
Theta Sigma
Theta Tau
Theta Theta
Theta Upsilon
Theta Xi
Theta Zeta
Unassigned Chapter
Upsilon
Upsilon Omega
Xi
Xi Omega
Zeta
Zeta Alpha
Zeta Beta
Zeta Chi
Zeta Delta
Zeta Epsilon
Zeta Eta
Zeta Gamma
Zeta Iota
Zeta Kappa
Zeta Lambda
Zeta Mu
Zeta Nu
Zeta Omega
Zeta Omicron
Zeta Phi
Zeta Pi
Zeta Psi
Zeta Rho
Zeta Sigma
Zeta Tau
Zeta Theta
Zeta Upsilon
Zeta Xi
Zeta Zeta
Required Field
Reclaimed By Brother
Required Field
Reclaimed Brother Chapter
(None)
Alpha
Alpha Alpha
Alpha Alpha Omega
Alpha Beta
Alpha Beta Omega
Alpha Beta Omega
Alpha Chi
Alpha Chi Omega
Alpha Delta
Alpha Delta Omega
Alpha Epsilon
Alpha Epsilon Omega
Alpha Eta
Alpha Eta Omega
Alpha Gamma
Alpha Gamma Omega
Alpha Iota
Alpha Iota Omega
Alpha Kappa
Alpha Kappa Omega
Alpha Lambda
Alpha Lambda Omega
Alpha Mu
Alpha Mu Omega
Alpha Nu
Alpha Nu Omega
Alpha Omega
Alpha Omega Omega
Alpha Omicron
Alpha Omicron Omega
Alpha Phi
Alpha Phi Omega
Alpha Pi
Alpha Pi Omega
Alpha Psi
Alpha Psi Omega
Alpha Rho
Alpha Rho Omega
Alpha Sigma
Alpha Sigma Omega
Alpha Tau
Alpha Tau Omega
Alpha Theta
Alpha Theta Omega
Alpha Upsilon
Alpha Upsilon Omega
Alpha Xi
Alpha Xi Omega
Alpha Zeta
Alpha Zeta Omega
Beta
Beta Alpha
Beta Alpha Omega
Beta Beta
Beta Beta Omega
Beta Chi
Beta Chi Omega
Beta Delta
Beta Delta Omega
Beta Epsilon
Beta Epsilon Omega
Beta Eta
Beta Eta Omega
Beta Gamma
Beta Gamma Omega
Beta Iota
Beta Iota Omega
Beta Kappa
Beta Kappa Omega
Beta Lambda
Beta Lambda Omega
Beta Mu
Beta Mu
Beta Mu Omega
Beta Nu
Beta Nu Omega
Beta Omega
Beta Omega Omega
Beta Omicron
Beta Omicron Omega
Beta Phi
Beta Phi Omega
Beta Pi
Beta Pi Omega
Beta Psi
Beta Psi Omega
Beta Rho
Beta Rho Omega
Beta Sigma
Beta Sigma Omega
Beta Tau
Beta Tau Omega
Beta Theta
Beta Theta Omega
Beta Upsilon
Beta Upsilon Omega
Beta Xi
Beta Xi Omega
Beta Zeta
Beta Zeta Omega
Chi
Chi Omega
Delta
Delta Alpha
Delta Alpha Omega
Delta Beta
Delta Beta Omega
Delta Chi
Delta Delta
Delta Delta Omega
Delta Epsilon
Delta Epsilon Omega
Delta Eta
Delta Eta Omega
Delta Gamma
Delta Gamma Omega
Delta Iota
Delta Iota Omega
Delta Kappa
Delta Kappa Omega
Delta Lambda
Delta Lambda Omega
Delta Mu
Delta Mu Omega
Delta Nu
Delta Nu Omega
Delta Omega
Delta Omicron
Delta Omicron Omega
Delta Phi
Delta Pi
Delta Psi
Delta Rho
Delta Sigma
Delta Tau
Delta Theta
Delta Theta Omega
Delta Upsilon
Delta Xi
Delta Xi Omega
Delta Zeta
Delta Zeta Omega
Epsilon
Epsilon Alpha
Epsilon Beta
Epsilon Chi
Epsilon Delta
Epsilon Epsilon
Epsilon Eta
Epsilon Gamma
Epsilon Iota
Epsilon Kappa
Epsilon Lambda
Epsilon Mu
Epsilon Nu
Epsilon Omega
Epsilon Omicron
Epsilon Phi
Epsilon Pi
Epsilon Psi
Epsilon Rho
Epsilon Sigma
Epsilon Tau
Epsilon Theta
Epsilon Upsilon
Epsilon Xi
Epsilon Zeta
Eta
Eta Alpha
Eta Beta
Eta Chi
Eta Delta
Eta Epsilon
Eta Eta
Eta Gamma
Eta Iota
Eta Kappa
Eta Lambda
Eta Mu
Eta Nu
Eta Omega
Eta Omicron
Eta Phi
Eta Pi
Eta Psi
Eta Rho
Eta Sigma
Eta Tau
Eta Theta
Eta Upsilon
Eta Xi
Eta Zeta
Gamma
Gamma Alpha
Gamma Alpha Omega
Gamma Beta
Gamma Beta Omega
Gamma Chi
Gamma Chi Omega
Gamma Delta
Gamma Delta Omega
Gamma Epsilon
Gamma Epsilon Omega
Gamma Eta
Gamma Eta Omega
Gamma Gamma
Gamma Gamma Omega
Gamma Iota
Gamma Iota Omega
Gamma Kappa
Gamma Kappa Omega
Gamma Lambda
Gamma Lambda Omega
Gamma Mu
Gamma Mu Omega
Gamma Nu
Gamma Nu Omega
Gamma Omega
Gamma Omega Omega
Gamma Omicron
Gamma Omicron Omega
Gamma Phi
Gamma Phi Omega
Gamma Pi
Gamma Pi Omega
Gamma Psi
Gamma Psi Omega
Gamma Rho
Gamma Rho Omega
Gamma Sigma
Gamma Sigma Omega
Gamma Tau
Gamma Tau Omega
Gamma Theta
Gamma Theta Omega
Gamma Upsilon
Gamma Upsilon Omega
Gamma Xi
Gamma Xi Omega
Gamma Zeta
Gamma Zeta Omega
Iota
Iota Alpha
Iota Beta
Iota Delta
Iota Epsilon
Iota Gamma
Iota Omega
Kappa
Kappa Omega
Lambda
Lambda Omega
Mu
Mu Omega
Nu
Nu Omega
Omega
Omicron
Omicron Omega
Phi
Phi Omega
Pi
Pi Omega
Psi
Psi Omega
Rho
Rho Omega
Sigma
Sigma Omega
Tau
Tau Omega
Theta
Theta Alpha
Theta Beta
Theta Chi
Theta Delta
Theta Epsilon
Theta Eta
Theta Gamma
Theta Iota
Theta Mu
Theta Nu
Theta Omega
Theta Omicron
Theta Phi
Theta Pi
Theta Psi
Theta Rho
Theta Sigma
Theta Tau
Theta Theta
Theta Upsilon
Theta Xi
Theta Zeta
Unassigned Chapter
Upsilon
Upsilon Omega
Xi
Xi Omega
Zeta
Zeta Alpha
Zeta Beta
Zeta Chi
Zeta Delta
Zeta Epsilon
Zeta Eta
Zeta Gamma
Zeta Iota
Zeta Kappa
Zeta Lambda
Zeta Mu
Zeta Nu
Zeta Omega
Zeta Omicron
Zeta Phi
Zeta Pi
Zeta Psi
Zeta Rho
Zeta Sigma
Zeta Tau
Zeta Theta
Zeta Upsilon
Zeta Xi
Zeta Zeta
Required Field
FormType
(None)
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