Beta Eta Directory Update

Brothers of Beta Eta Zeta, please update your biographical information for a BHZ Directory that will be printed early 2010. By updating your information, you will be added to the email database for the Central Florida Alumni Association. If you do not want to be part of CFLXA, then just indicate that on the Directory Registration Page.

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NOTE: Please make sure you provide a valid email address and phone number!

* denotes a required field

*First Name:

Required Field.

Middle Name:

*Last Name:

Required Field.

Suffix:

*College/University where you were initiated:

Required Field.

*Zeta Number (enter DK if you don't know):

Required Field.

*Street Address:

Required Field.

Street Address Line 2:

*City:

Required Field.

*State:

Required Field.

*Zip Code 'DDDDD or DDDDD-DDDD':

Required Field. Valid Format is: DDDDD or DDDDD-DDDD

*County you live in....not Country:

Required Field.

*Phone '(DDD) DDD-DDDD':

 Required Field. Valid Format is: (DDD) DDD-DDDD

Secondary Phone '(DDD) DDD-DDDD':

 Valid Format is: (DDD) DDD-DDDD

*E-mail Address:

Required Field. Valid Format is: XYZ@XYZ.XYZ

Alternate E-mail Address:

Required Field. Valid Format is: XYZ@XYZ.XYZ

Occupation:

Interests:

Reffered to CFLXA by: