Regular Membership FormChoose your Membership Level below: Donation Amount: $ 100.00 Regular ($100)Associate ($100)Sustaining Life ($100)Life Membership ($1000) Make this donation every dayweekmonthquarteryear Select Payment Method Stripe - Checkout Personal Info First Name * Last Name * Email Address * Make this an anonymous donation. Address Line 1 * Required Address Line 2 City * Required State * Required Zip Code * Required Phone * Required Class Year * Required Major * Required Chapter Affiliation * Required - Chapter Affiliation - Attala County Bolivar County Carroll-Montgomery County Greater Washington County Humphreys County Holmes County Harrison County Grenada County Meridian County LeFlore County Jackson County Jackson-Hinds County Vicksburg-Warren County Northeast Mississippi Tallahatchie County Sunflower County Sharkey-Issaquena County Panola-Lafayette County Oktibbeha County Natchez Washington DC Metro Suburban Illinois Area St. Louis Area Greater Memphis Area Detroit Chicago Area Atlanta Metro 1st Carolina At-Large/No Local Chapter Donate quickly and securely with Stripe How it works: A Stripe window will open after you click the Donate Now button where you can securely make your donation. You will then be brought back to this page to view your receipt. 25.00 Regular Membership Form Donation Total: $100.00 One Time