Alpha Epsilon Pi :: Pi Upsilon Chapter

Please fill out the following form as completely as possible, thank you.

Basic Information:

Name:

Nickname:

Address:

City:

State:

Zip:

Phone number:

E-mail:

If married, Wife's name:

Children's names and ages:

Pledge Class:

Offices Held:

Graduation Year:

Degree earned:

Current Employer:

Chapter Involvment:

Are you intrested in being a part of an Alumni Board?:

Yes No

What is the best way of contacting you?

Phone E-mail Other

If Other,

As an alumnus of the Pi Upsilon chapter of AEPi, what do yo expect from the active brothers? What would you like to see more of?

How often would you like to receive updates and news from the chapter?

What would be your preferred method of news correspondence?

E-mail Newsletter Website Letter Other

If Other,

Alumni Events in 2009:

Would you be interested in an Alumni Event Fall 2009 for our 55th Anniversary?

Yes No

If so, which weekend(s) would you be able to attend?

Oct. 17 vs. OHIO STATE
Oct. 24 vs ILLINOIS
Nov. 14 vs. MICHIGAN STATE

Ideas for the Fall 2009 Alumni Event and/or the chapter:

Note: If you are still in contact with your pledge brothers, please inform them of our efforts so that we are able to reach as many brothers as possible.