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About
Chapter Info
Tampa (FL) Alumni
Officers
Silhouettes
Support
Pay Dues
LinKs
Fraternity History
National History
Founders
News
Foundation
Guide Right
86th GCM
Gallery
Brothers Only
TAC C5MF
TAC Membership Form
First Name
*
MI
*
Last Name
*
Birth Month
*
January
February
March
April
May
June
July
August
September
October
November
December
Birth Day
*
Birth Year: Ex. - 1911
*
Cell Phone Number
Email
*
Home Address
*
City
*
State: ex. FL
*
Zip Code
*
Chapter of Initiation: ex. "Alpha Chapter" , "TAC"
*
Date of Initiation: Ex. - 05251990
*
Membership Number
*
Line/Nickname
Line Number: ex. "3"
Life Member
*
Yes
No
Life Member Number
Additional Info *if necessary*
Military
*
Yes
No
Retired
*
Yes
No
Correspondence Preference - Check all that apply
*
Email
Telephone
Mailing Address
Committee(s) you are interested in supporting
*
Spouse Name:
Children Name(s):
Submit
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