Alabama Statewide Organization Omega Psi Phi Fraternity, Inc. Life Membership Application

Alabama Statewide Organization Omega Psi Phi Fraternity, Inc. Life Membership Application
The Alabama Statewide Organization Life Membership fee is $350.00. The applicant will NOT be considered a life member of the Alabama Statewide Organization until the one time fee is paid in full. Furthermore, Alabama Statewide Organization Life Members must maintain appropriate International, District and Chapter dues in order to be considered financial. After confirmation of payment the name of brother applying for ASO Life Membership will be added to the ASO website. A copy of this application will be emailed to the applying brother as a receipt and confirmation.
Date:

MonthDayYear
Date
Life Membership Fee: ($350.00)
Name

First NameMiddle InitialLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone #
Format: (000) 000-0000.
Primary Email
example@example.com
Alternate Email
example@example.com
Control #
International Life Membership #
Current Chapter
Initiation Chapter
Initiation Date

MonthDayYear
Date
DO NOT WRITE BELOW THIS LINE. FOR OFFICE USE ONLY.
Alabama Statewide
Organization Life Member
Number Assigned:
Should be Empty: