Update Chapter Roll

Update The Chapter Roll

Please register on the PsiBeta.net chapter roll! This information will remain confidential and will only be used by Beta Theta Pi and the Psi Diamond Association to keep you up-to-date on important Psi news.(This does not update the Chapter Roll page on this site immediately.)
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Psi Roll Number

Class Year

First Name/Initial Ex: John or Jonathan R or Jonathan R 'John'

Last Name Ex: Doe or Doe Jr

Address to receive Psi mail:
We prefer your home address please.

Street Address

City

State/Province USA and Canada

Zip/Postal code 12345 or 12345-1234 or A1B 2C3

Country

Phone and Internet:

Day/Work Phone

Evening/Home Phone

Cell Phone

E-mail address

Web Page address

Employment:

Title

Company Name

How do you prefer to be contacted? (check all that apply)

Send me E-mail with important Psi news
Publish my E-mail in the secure (non-public) PsiBeta.net directory
Send me US Mail with important Psi news
Call me at Work
Call me at Home
Call my Cell Phone

Psi Roll Number
Class Year
First Name/Initial		Ex: John or Jonathan R or Jonathan R 'John'
Last Name		Ex: Doe or Doe Jr
	Address to receive Psi mail: We prefer your home address please.
Street Address
City
State/Province		USA and Canada
Zip/Postal code		12345 or 12345-1234 or A1B 2C3
Country
	Phone and Internet:
Day/Work Phone
Evening/Home Phone
Cell Phone
E-mail address
Web Page address
	Employment:
Title
Company Name