Apply for Access to Members' Area

Before you may access the Members' Area of the Dartmouth Beta web site, we ask that you complete and submit the form below. We'll review the form and e-mail you when your access has been activated. Please allow 24-48 hours for a response.

The information collected here is solely for the use of Dartmouth Beta. We will post only your name, class year and e-mail address in the online Registry in the Members' Area of this web site; all other information will be for the internal use of Dartmouth Beta. We will never sell or otherwise divulge your personal information to any third party.

In return, you must agree not to reveal your username or password to anyone.

If you have questions, please e-mail the site administrator at admin@dartmouthbeta.org.

Please click the checkbox below to indicate that you agree with these terms.

I agree to the Terms and Conditions above.

First name:

Last name:

Class: (example: 1965)

E-mail address:
 

Daytime phone:

Evening phone:
 

Mailing address: (use two lines if necessary)

City:

State/Prov.:

Zip/Postal Code:

Choose a username:

Choose a password:

Enter password again to verify: