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The Western Region of Alpha Phi Alpha Fraternity, Inc. welcomes you!
Thank you for your interest in carrying out the Initial Membership Development Process (IMDP). Click start to begin a request for IMDP training.
10
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1
Requested Train By Date
*
This field is required.
Date by which an opportunity for IMDP training & certification is desired
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Date
Year
Month
Day
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2
Requested Training Start Time
*
This field is required.
Time at which an opportunity for IMDP training & certification is desired
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Hour
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Minutes
AM
PM
AM
AM
PM
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3
Planned Training Location
*
This field is required.
Please provide a complete address including street number, city and zip code. It is the training requestor's responsibility to secure a suitable training location for the training requested
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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4
Requestor
*
This field is required.
"Requestor" here and in the subsequent questions refers to the Alpha brother requesting an IMDP training session.
First Name
Middle Name
Last Name
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5
Requestor's Email
*
This field is required.
example@example.com
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6
Requestor's District
*
This field is required.
Great Northwest District
Northern California District
Rocky Mountain District
Southern California District
Tri-State District
Great Northwest District
Northern California District
Rocky Mountain District
Southern California District
Tri-State District
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7
Requestor's Chapter
*
This field is required.
Alpha Delta
Alpha Epsilon
Alpha Xi
Beta Psi Lambda
Delta Psi Lambda
Delta Tau Lambda
Epsilon Beta
Epsilon Mu
Epsilon Zeta Lambda
Eta Pi Lambda
Eta Psi Lambda
Eta Sigma
Eta Sigma Lambda
Gamma Chi Lambda
Gamma Phi Lambda
Gamma Xi
Iota Mu Lambda
Iota Nu Lambda
Iota Omicron Lambda
Iota Psi
Iota Psi Lambda
Iota Tau
Iota Zeta Lambda
Kappa Alpha Lambda
Kappa Eta Lambda
Kappa Omicron Lambda
Mu Beta Lambda
Mu Chi
Mu Eta
Mu Kappa
Mu Phi Lambda
Mu Sigma Lambda
Mu Xi Lambda
Nu Beta Lambda
Nu Epsilon Lambda
Nu Sigma
Nu Tau Lambda
Nu Zeta Lambda
Omicron Tau
Omicron Theta Lambda
Phi Beta
Pi Epsilon
Pi Gamma
Pi Kappa
Pi Xi Lambda
Pi Zeta Lambda
Rho Beta
Sigma Psi
Tau Sigma
Theta Pi Lambda
Upsilon Chi
Upsilon Rho
Xi Iota Lambda
Xi Pi
Xi Rho
Zeta Beta Lambda
Zeta Pi Lambda
Zeta Sigma Lambda
Zeta Theta
Alpha Delta
Alpha Epsilon
Alpha Xi
Beta Psi Lambda
Delta Psi Lambda
Delta Tau Lambda
Epsilon Beta
Epsilon Mu
Epsilon Zeta Lambda
Eta Pi Lambda
Eta Psi Lambda
Eta Sigma
Eta Sigma Lambda
Gamma Chi Lambda
Gamma Phi Lambda
Gamma Xi
Iota Mu Lambda
Iota Nu Lambda
Iota Omicron Lambda
Iota Psi
Iota Psi Lambda
Iota Tau
Iota Zeta Lambda
Kappa Alpha Lambda
Kappa Eta Lambda
Kappa Omicron Lambda
Mu Beta Lambda
Mu Chi
Mu Eta
Mu Kappa
Mu Phi Lambda
Mu Sigma Lambda
Mu Xi Lambda
Nu Beta Lambda
Nu Epsilon Lambda
Nu Sigma
Nu Tau Lambda
Nu Zeta Lambda
Omicron Tau
Omicron Theta Lambda
Phi Beta
Pi Epsilon
Pi Gamma
Pi Kappa
Pi Xi Lambda
Pi Zeta Lambda
Rho Beta
Sigma Psi
Tau Sigma
Theta Pi Lambda
Upsilon Chi
Upsilon Rho
Xi Iota Lambda
Xi Pi
Xi Rho
Zeta Beta Lambda
Zeta Pi Lambda
Zeta Sigma Lambda
Zeta Theta
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8
Regional Trainer Requested
Here, indicate (from the drop-down menus below) up to 3 selections for desired regional IMDP trainer. You must select at least one from the currently available list
Please Select
Allen Ahmadi
Ondra Berry
Chris Billingsley
Calvin McNeill
Bradford Cook
Jarred Galbreath
Levern Tyrone Randall
Jamil Oquinn
Frederick Jackson
Harvest Thomas
Gary Green
Noah Hayes
Virgil Torrence
Marlon Holmes
Bobby Jennings
Gary Green
Ken Youngblood
Donald Long
Marquis Scott
Please Select
Please Select
Allen Ahmadi
Ondra Berry
Chris Billingsley
Calvin McNeill
Bradford Cook
Jarred Galbreath
Levern Tyrone Randall
Jamil Oquinn
Frederick Jackson
Harvest Thomas
Gary Green
Noah Hayes
Virgil Torrence
Marlon Holmes
Bobby Jennings
Gary Green
Ken Youngblood
Donald Long
Marquis Scott
requested regional trainer - 1st choice
Please Select
Allen Ahmadi
Ondra Berry
Chris Billingsley
Calvin McNeill
Bradford Cook
Jarred Galbreath
Levern Tyrone Randall
Jamil Oquinn
Frederick Jackson
Harvest Thomas
Gary Green
Noah Hayes
Virgil Torrence
Marlon Holmes
Bobby Jennings
Gary Green
Ken Youngblood
Donald Long
Marquis Scott
Please Select
Please Select
Allen Ahmadi
Ondra Berry
Chris Billingsley
Calvin McNeill
Bradford Cook
Jarred Galbreath
Levern Tyrone Randall
Jamil Oquinn
Frederick Jackson
Harvest Thomas
Gary Green
Noah Hayes
Virgil Torrence
Marlon Holmes
Bobby Jennings
Gary Green
Ken Youngblood
Donald Long
Marquis Scott
requested regional trainer - 2nd choice
Please Select
Allen Ahmadi
Ondra Berry
Chris Billingsley
Calvin McNeill
Bradford Cook
Jarred Galbreath
Levern Tyrone Randall
Jamil Oquinn
Frederick Jackson
Harvest Thomas
Gary Green
Noah Hayes
Virgil Torrence
Marlon Holmes
Bobby Jennings
Gary Green
Ken Youngblood
Donald Long
Marquis Scott
Please Select
Please Select
Allen Ahmadi
Ondra Berry
Chris Billingsley
Calvin McNeill
Bradford Cook
Jarred Galbreath
Levern Tyrone Randall
Jamil Oquinn
Frederick Jackson
Harvest Thomas
Gary Green
Noah Hayes
Virgil Torrence
Marlon Holmes
Bobby Jennings
Gary Green
Ken Youngblood
Donald Long
Marquis Scott
requested regional trainer - 3rd choice
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9
Additional Comments
Do you have any additional comments to share with the Western Region Vice President or Western Region IMDP Management Team? (e.g. special circumstances, time constraints, IMDP related college chapter viability concerns, etc. )
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10
Please verify that you are human
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This field is required.
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