General Inquiry Form
Complete this Inquiry Form to obtain additional information about the organization or send personal concerns. We will analyze your inquiry and return to you by email or phone. Please
Member Name
First Name, Middle Name, Last Name, Suffix
First Name *
Middle Name
Last Name *
Contact Information
Personal and Emergency Contact Information
PHIMAN Email *
Cell Phone *
Have you paid your dues for this semester/academic year? *
Please select your current Class Status: *
Affiliated Chapter *
Please select (1) *
Briefly, explain the nature of your inquiry *
I have agreed to submit this inquiry by electronic means. I understand that the ERTK will make every effort within their fraternal jurisdiction to address the issue/concerns submitted. If any of the inquiries carried a concern beyond the scope of the organization's rules and regulations and requires legal consultation and involvement, the organization reserves the right to seek legal assistance and protect the organization and its constituents.

I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.
Submission *
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