Omega Network Form

Omega Member Information

Please enter information pertaining specifically to the member/brother for networking purposes.
Enter the member's first name only.
Enter the member's last name only.
Please enter your full control number including the two leading zeros. It should be nine (9) digits in length.
Please enter your personal email address - not your work or business officer email address.
Enter your phone number (Cell Preferred)
Please enter your chapter name ONLY. Please do not add "Chapter" or your chapter nickname.
Please enter your initiation date. (ex. 12/01/1975)
Please enter your profession. (ex. Medical Doctor, Lawyer, Attorney, IT Specialist, Nurse, Dentist, Engineer, Financial Analyst, Banker) If you are unemployed, please enter Unemployed. If you are retired, please Retired.

Business/Professional Section

Please enter the name of the company where you are employed.
Please enter the type of the business you are employed. (ex. Engineering, IT, Banking)
If your company has a website, please enter it here. (ex.
Please type your (brother) "CURRENT" home city.
Please type your (brother) "CURRENT" home postal code.