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* Campus

Organization
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* Submitted by, Name

* E-Mail

* Phone


Number of Members


* Main House Phone

Alternate House Phone



House Address (No P.O. Boxes)


City

State

Zip Code

+4



Correspondence Address


City

State

Zip Code

+4



* President's Name

* President's Phone

* President's E-Mail


* Treasurer's Name

* Treasurer's Phone

* Treasurer's E-Mail


* Composite Chairman's Name

* Composite Chairman's Phone

* Composite Chairman's E-Mail


* Officer Election Date



Comments


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