Carlsbad Laguna Temecula Alumni Chapter of Kappa Alpha Psi Fraternity

Please answer all questions and email (nupesofcly@gmail.com) any additional documentation to support your application for membership consideration. If a question is not applicable to you, please indicate as such.

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Name: Email: Comment:

First Name

Last Name

Chapter Initiated *

Date Initiated *

How Many on your Line? *

Duece Club/ Tre Club

Email Address *

Birthday *

Month / Day

Address

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

Name of your Last Chapter you were Financial? *

UnderGrad or Alumni

Provide a Member Reference.. (Last, First Name) *

provide a Brother from Kappa Alpha Psi Fraternity

Married

Are You Registered to Vote?

Kappa re-engagement form for upcoming events from Carlsbad Laguna Temecula Alumni Chapter of Kappa Alpha Psi Fraternity

Kappa re-engagement form for upcoming events from
Carlsbad Laguna Temecula Alumni Chapter
of Kappa Alpha Psi Fraternity