Request for Courtesy Committee Support

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Please complete this form to request assistance, prayer, or to inform the brothers you desire uplift.

For whom are you making this request?

For Myself

For Another Brother in Need (If you select this box, please answer each question below as if answering for the brother in need.

Last Name (If you are completing for another brother, enter their last name) *

First Name (If you are completing for a another brother, enter their first name) *

Year Initiated (If completing for another brother, enter their initiation year) *

In what chapter were you initiated? (If completing for another brother, enter their initiating chapter) *

Type of Request *

Prayer

Bereavement

Celebration

Praise Report

Other:

Please provide any details you can share about your request so that we can effectively serve you? *

Is it ok if we share your request with the Brothers of Gamma Pi? *

Yes

Is it ok if we include your request on the Omega IHQ Prayer Call? *

Yes

What is the best mobile number to reach you? (if completing for another brother, please enter their number)

What is the best email to reach you? (if completing for another brother, please enter their email)

Submit

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