Alumnae Data Zip List Request Form

Alumnae Data Zip List Request
National Headquarters needs the following information in order to compile a name and address list of the Tri Sigma alumnae within a 30 miles radius of the requested geographic area.
From what zip code would you like the radius searched? *
What radius are you requesting?

15 mile radius 30 mile radius 45 mile radius 60 mile radius Whole state
Please select what you would like listed on the report (select all that apply):

Name Mailing address Phone E-mail Collegiate Chapter Alumnae Chapter Initiation data Alumnae Dues paid
Please list where this list will need to be e-mailed to:
Name
E-mail *
Should be Empty: