EmailMe Form - ALD Membership Order Form

Name of your institution *

Input the name of your institution exactly as it should appear on your membership certificates.

Your chapter's initiation date *

MM / DD / YYYY

This is the date that will be printed on your membership certificates.

Shipping Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Please input a valid shipping address where the certificates should be sent. Please do not submit an off-campus address; ALD will not ship certificates to an off-campus address.

Name of person placing this order *

First Last

E-mail *

Confirm e-mail

Phone

### - ### - ####

Number of students invited to join Alpha Lambda Delta *

Number of new, dues-paying student members *

Number of new honorary members

Number of new dues-waived student members

Number of lapel pins requested

Number of key charms requested

New Members

Please input your list of new members into the space below, or use the "Upload file" button to upload a text file, Word document, or spreadsheet containing your new student members' names.

Please make sure to format names in STANDARD FORMAT - John Doe; Jane Roe; Mary Jones. Do NOT use Last/First format: Doe, John; Roe, Jane; Jones, Mary. Do NOT use all caps - capitalize the names as they should appear on the certificates.

New members

Input names in standard format (First name followed by last name, no punctuation). Please put each name on a different line.

File Upload

Upload a text file, Word document, or spreadsheet containing your new members' names.

Honorary members