Supreme Council Visit Request Form

Having an event at your Chapter or Alumni Association? Please complete the form below to
request event attendance from a member of the Supreme Council.

Your Name*

First NameLast Name

Your Email Address*

example@example.com

Your Phone Number*

Area CodePhone Number

YOUR Role and Responsibility*

Event Host Type*

ChapterAlumni AssociationProvinceOther

Province / Association Name

College / University Name

Event Type*

Anniversary Milestone*

Event Start Date/Time*

MonthDayYearHourMinutesAM/PM Option

Event End Date/Time*

MonthDayYearHourMinutesAM/PM Option

Your Event End Date/Time must come after your Event Start Date/Time. Please revise your request.

Event Location Address*

Street Address

Street Address Line 2

CityState

Zip Code

Please provide brief details about this event*

How many brothers/guests usually attend this event -OR- do you anticipate attending this event?

Please provide insight into the significance of this event and how/why a Supreme Council member being in attendance is important?

What would the expectations of the Supreme Council member be at/during the event?