Mailing Label Order Form

Use this form to:	Request self-adhesive labels containing the addresses of your chapter members, other alumni in the area, and members of the National Organization.
This form sends mail to:	Rhonda Halcomb (rhonda@triangle.org) in the Headquarters Your email address entered below
Instructions:	Complete the fields on this page and click the "Submit Request" button to send your request to the National Headquarters. If the form is not working, you may print this page and send it to the National Headquarters via regular mail.
Comments:	The National Headquarters staff will create free mailing lists and labels only on the first and third Tuesdays of each month. Requests to have labels generated on either of these days must be received two days in advance. If the requests are not received two days in advance or if the request cannot be completed on the first or third Tuesday (i.e. you submit your request on a Wednesday and need the labels by that Friday) there will be a charge of $.10 per label or $5 for a list.

Your Name:
Your Email Address:
Your Chapter:
Number of sets desired:
Date needed: (see Comments above)
Format:	Labels Mailing List
Sequence:	Alphabetical ZIP code

Include names for the following:	Yes No	Chapter alumni
	Yes No	Chapter undergraduates
	Yes No	All members living within a specified ZIP code range (please specify in "Other comments or instructions" below)
	Yes No	National Headquarters
	Yes No	National Council
	Yes No	Undergraduate Presidents
	Yes No	Alumni Presidents
	Yes No	Members of BLF and Education Foundation
Name and address to send labels to:	(Since labels are often sent UPS, be sure to give a street address along with your PO Box, if applicable)
Other comments or instructions: