Bridge Builders Form

Brothers, each chapter should submit the names of brothers that are part of this elite group of men.

Tenth District 2017
Golden Bridge Builders
Chapter Invitation

The committee is requesting that the Basileus or KRS send a listing of 50 year or more brothers (with the information listed below) and planning to attend the District Convention no later than March 8, 2017 to Brother Willie Lewis (archives@omega10thdistrict.org). If you would like to speak with Brother Willie Lewis his cellphone number is 312-287-6571. Thank-you in advance for your support.

Enter Bridge Builder's First Name. Please use proper spelling with the first letter capitalized.
Enter Bridge Builder's Last Name. Please use proper spelling with the first letter capitalized.
Enter Bridge Builder's personal email address. If you are assisting another brother, please your chapter KRS email address.
Please enter your phone number - preferably your cell phone.
Enter your Control Number with two leading zeros. Ex. 009999999
Ex. Pi Beta/Illinois State University. Please use proper spelling with the first letter capitalized. DO NOT TYPE CHAPTER at the END.
Please enter the date of the Brother's initiation. If you don't have the full date, please just put the year.
Ex. Pi Beta/Illinois State University. Please use proper spelling with the first letter capitalized. DO NOT TYPE CHAPTER at the END.
Enter Bridge Builder's full home address.
Ex. 123 S. Buck Rd.
Enter your city - Ex. Chicago. Please use proper spelling with the first letter capitalized.
Enter brother's zip code - Ex. 60606.
Please enter the date of the Brother's possible arrival.

Submitting Chapter KRS Information:

Enter Chapter KRS First Name. Please use proper spelling with the first letter capitalized.
Enter Chapter KRS Last Name. Please use proper spelling with the first letter capitalized.
Enter Chapter KRS personal email address. If you are assisting another brother, please your chapter KRS email address.
Enter your Chapter KRS Control Number with two leading zeros. Ex. 009999999