REGISTER FOR ACCESS
Personal Information
First Name:
Middle Name:
Last Name:
Suffix:
E-Mail Address:
Home Phone:
Format: XXX-XXX-XXXX
Cell Phone:
Format: XXX-XXX-XXXX
Country of Citizenship:

Membership Information
CANDIDATES: Please select the name of the Chapter through which you are aspiring. Unless you are aspiring via Cornell University DO NOT choose Alpha as the Chapter.

CANDIDATES: Enter your Application ID where requested. IF YOU DO NOT HAVE AN APPLICATION ID, DO NOT ENTER A RANDOM NUMBER. ENTERING A FALSE ID IS GROUNDS FOR CONSIDERATION TO NOT ALLOW YOU TO PROCEED. If you don't have an ID, go to http://www.alphaphialpha.net and follow Membership -> Aspiring Members -> Request an Application. Fill in the form and you will receive your application ID.

FOR BROTHERS: Select the Chapter to which you currently belong and enter your ALPHANET MEMBERSHIP ID NOT your Life Member Number.
Are You A Brother of A-Phi-A: YES NO
Chapter:
AlphaNet/Application ID:
Account Security
Please enter a login ID that you can use to log back into system. ID must be a minimum length of 8 characters and maximum of 25 characters.
Login ID:
Confirm Login ID:
Please enter the password that you can use to log back into system. ID must be a minimum length of 8 characters and maximum of 15 chars.
Password:
Confirm Password:
The last six digits of your SS# is used as a unique identifier for all members and aspiring members. The number will only be visible to authorized administrators.

Use NUMBERS ONLY - do NOT input dashes AND DO NOT PUT ALL ZEROES.
Last 6 digits of SSN?

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