Financial &
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Member Registration Form

Name(Required)

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Username(Required)

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Email(Required)

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Password(Required)

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Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Gender

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Are You Financial or Non Financial(Required)

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As a Financial Member, are you an Undergrad, Alumni or Life Member?(Required)

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As a Non-Financial Member, are you an Undergrad, Alumni or Life Member?

Undergrad

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Are you an Undergrad, Alumni or Life Member?(Required)

Undergrad

Alumni

Life Member

Line Name

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Ship Name

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Crossing Date

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Crossing Chapter(Required)

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Current Chapter(Required)

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Region(Required)

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Are you a part of The Grand Executive Board, Grand Council, Board Of Directors or a Regional Leadership Team?(Required)

Yes

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Please choose which Iota Leadership Team you are apart of.

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Leadership Team Tag ID

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Please choose your National Elected Position.

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Please choose your Board of Directors Elected Position.

Choose Your Highest Position

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Please choose your Gulf Coast Regional Position.

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Please choose your Eastern Regional Position.

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Please choose your Atlantic Coast Regional Position.

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Please choose your Midwest Regional Position.

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Please choose your Ohio Valley Regional Position.

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Please choose your Southern Regional Position.

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Please choose your Far West Regional Position.

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Elected Position Tag ID

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Profile Type Tag ID

How Many Stars Are In The Sky?(Required)

Which One Shines The Brightest(Required)

Which Chapter is The Hardest Ever Established?(Bonus)

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Financial & Non-Financial Membership

Join Now!

Not A Financial Member? Click Here to pay your dues at the Iota Phi Theta National Website

Member Registration Form

Financial &
Non-Financial Membership