Southfield Alumni Chapter Reclamation Form

Reclamation Form

2025-2026
WE NOW HAVE A PAYMENT PLAN AVAILABLE!

Click on the link below to be taken to the monthly plan renewal form:

Make Your First Payment Today!

- OR -

Continue the form below to pay your dues in full.
Note: Payment of dues on this site does not include annual Grand Chapter dues. The only way to be considered "reclaimed" is to pay Alumni and Grand Chapter Dues. Click on the link below and you can pay Grand Chapter dues through the Brothers Only Login under the Members Only tab on www.kappaalphapsi1911.com.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email (please use a personal email if possible)*
example@example.com
Birth Date*

MonthDayYear
Emergency Contact*

First NameLast Name
Emergency Contact Mobile Phone Number*
Please enter a valid phone number.
Emergency Contact Email
example@example.com
What Kappa brother is responsible for you being reclaimed?

First NameLast Name
At what level did you pledge Kappa Alpha Psi?*
Chapter of Initiation (use greek letter designation as well as university name if it applies)?*
Date of Initiation?

MonthDayYear
Date
What is your membership number (type "unknown" if you do not know it at this time)?*
Do you have a desire to contribute to any of the following committees (you may choose more than one)?

Community Service CommitteeHealthy Kappa CommitteeHousing CommitteeKappa Kulinary CommitteeGuide Right/Kappa LeagueSouthfield Kappa FoundationVintage Kappa CommitteeEmerging Leaders of Kappa (ELOK)Political & Social Action CommitteeReclamation CommitteeRAN (Recognition, Achievement, Networking) CommitteeSocial Events CommitteeStrategic Planning CommitteeTechnology CommitteeUndergraduate Advisor Committee

Select Only One (payment includes dues and processing fees)*

Northern Province Life Member(Current life member but not financial at the alumni level)

$294.00 Quantity

Non-Northern Province Life Member(Non-life member but not financial at the alumni level)

$351.00 Quantity

Total

$0.00

Credit Card

Should be Empty: