The Lambda Chi Alpha Fraternity
Phi-Kappa Zeta Alumni Association

Alumni Information Form

The alumni association needs your assistance in updating its membership records.  Please provide as much of the following information that you would like to share.  The information submitted will be used for fraternal purposes only.  After providing all of your information, be sure to click the "submit" button on the bottom of the page.  Thank you!

Name:      Phi-Kappa Number:   
Other Initiating Zeta and Number (if applicable):      E-Mail:   
Street Address:   
City:        State:        Zip Code:   
Your Birthday:        Wife's Name:   
Child #1 Name:        Child #2 Name:   
Child #3 Name:        Child #4 Name:   
Child #5 Name:   

Employer:   
Position/Title:   

Did you receive an undergraduate degree from AUM?      If so, what year did you graduate?   
Which undergraduate degree did you receive?   

Did you complete graduate studies?        From which university?   
Which graduate degree did you receive?          Year received?   

Please list all chapter/alumni association/house corporation offices and titles held:

Please list all current and past offices and titles held in philanthropic organizations:

Provide any further involvement in professional and organizations of personal interest in which you are involved:

Please check all of the following alumni involvement areas in which you may be interested:

            Alumni Advisory Board                     Alumni Association Board of Directors

            Alumni Association Committees         Bill Nowell Scholarship Committee

            Community Service Projects               Fraternity House Fundraising Effort

            High Pi                                            Twenty-Fifth Anniversary Banquet