Please fill this out as best you canIf you don't want specific information listed on the web site, 
don't give it here.




Full name:  

Address (line 1):  

Address (line 2):  

Phone:  

E-mail:  

Homepage:  

Scroll Number:  

Pledge Name (if applicable):  

Pledge Class:  

Years at Lyco/Years in TKE:  

Big Brother:  

Little Brother(s):
  

Offices/Positions Held in TKE:
  

Current Occupation:  

Wife:  

Children:
  



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