Entry form

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Email *

Email

Confirm Email

Mobile/Text Phone Number *

Birthday *

Significant Other's Name

Year Graduated *

Or asked to leave

Major - Other than Fraternity

Nickname

What did they call you (to your face)

Beta Sigma Lambda · We're a Bunch of Bastards

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