Please check the required fields
Full Name:
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Street Address:
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City:
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Zip:
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Home Phone:
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Cell Phone:
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E-Mail Address:
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Occupation:
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Years At TSU:
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Degree:
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Organizations / Affiliations:
Section Break Text Goes Here
Please Check Special Committee Interest(s):
Membership
College Fair/Recruitment
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Luncheon / Banquet
King & Queen Pageant
SWAC Backetball Tournament
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TSUNNA - Dallas Chapter Membership:
Annual Dues:
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$78
Includes National $50, Local $25, $3.00 Convenience Charge
Security Code:
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