Omega Chapter Submission

Please complete this form when a Brother transcends to Omega Chapter. Fields marked with an asterisk (*) are required.

Deceased Brother Name*
First Middle Last Suffix
Control Number
Current Chapter or Last Chapter Affiliated*
Chapter of Initiation*
Family Point of Contact (POC) - Full Name*
Please enter the Family Point of Contact's full name
Family POC - Phone Number*
Please enter the Family Point of Contact's phone number
Deceased Brother or Family Mailing Address*
Please enter the deceased Brother's or Family Mailing Address

Street Address Address Line 2 City State ZIP Code
Submitted By:*
Chapter Office Held by the Submitter:*
Email of Submitter:*
Enter Email Confirm Email