Registration for Purdue Theta Chi Alumni

In an effort to cut down on U.S. Postal costs, we are trying to go paperless and move towards electronic newsletters. This will create savings for our chapter. If you are not currently receiving emails from the Theta Chi - Alpha Delta Alumni association, or you would prefer to get your information sent to a different email address, please submit your email address.

Please provide information in the asterisk * boxes. Additional information is optional.

Thanks!

Alumni - Please Enter Your Information

First Name:	*
Last Name:	*
Address:	*
Address Cont'd:
City:	*
State:	*
Zip/Postal Code:	*
Country:
Primary Phone:
Email Address:	*
Alumni Database – company name / title:
Submissions for the alumni newsletter (i.e. family news – weddings/births/awards/promotions, etc..):