2021 WRVLC Omega Chapter Registry

2023 WRLC Omega Chapter Registry

2023 WRLC Omega Chapter Registry

Full Name of Transitioned Brother:

Transitioned Brother's Address City, State, and Zip Code:

Date of Birth to include City & State:

Chapter of Initiation and Date:

Date and cause of Dealth:

Chapter affiliation prior to Omega Chapter:

Full Name of Next of Kin:

Relation To Next of Kin Registry Submitted By:

Image Upload: Full color headshot Names to be considered by the Omega Chapter Registry must be submitted on or before Thursday, March 27, 2023, at 11:59 PM PDT.

2023 WRLC Omega Chapter Registry

2023 WRLC Omega Chapter Registry

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2023 WRLC Omega Chapter Registry 2023 WRLC Omega Chapter Registry

Submitted successfully! PBSWest.org will contacting you with more information.

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2023 WRLC Omega Chapter Registry

2023 WRLC Omega Chapter Registry

Submitted successfully!
PBSWest.org will contacting you with more information.