This form should be filled out by the undergraduate student serving as the group's main contact person.Your First NameYour Last NamePreferred e-mailPhone NumberPreferred Mailing AddressCity, State, ZIPWhat school do you wish to establish a chapter at?Number of members in potential interest groupWhen was the group organized?Why does your group wish to affiliate with Theta Chi?Have you or anyone else in your group been affiliated with another collegiate social fraternity?If yes, please describe the extent of your/their involvement (if not applicable, write N/A)Is there anything else you'd like to share with us?Submit
