Northwestern State University Interfraternity Council

Last Name

First Name

Home Phone Number

Cell Phone Number

NSU Student ID #

Email Address

Address

City

State

Zip Code

High School Attended

High School Graduation Date

List all High School and/or college activities/athletics/honors that you have received or participated in.

Name

Fraternity

Relationship to you

Are you a transfer student from another college/university or a continuing NSU student?

If yes, please list college/university

Official Web Page of Northwestern State University of Louisiana. Member, University of Louisiana System