Name of person submitting form: *
Phone Number: *
Email: *
Chapter Number/Name: *

My Position with the chapter (select one):*
President
Vice-President
Chapter Representative
Secretary
Treasurer
Coordinator
Other

Please make the following changes and/or additions (please fill in only those that apply, if your chapter does not have a person filling some positions, simply leave them blank or place n/a in the space):

President

Name:
Company:
Phone Number:
Email:

Vice-President

Name:
Company:
Phone Number:
Email:

Chapter Representative

Name:
Company:
Phone Number:
Email:

Secretary

Name:
Company:
Phone Number:
Email:

Treasurer

Name:
Company:
Phone Number:
Email:

Coordinator

Name:
Company:
Phone Number:
Email:

Newsletter Editor

Name:
Company:
Phone Number:
Email:

Chapter Meeting Information

Chapter Information

Chapter Events:
Add information about any upcoming special events including what it is, when and where and who to contact for more information. This information is also posted on the Chapter Events Calendar.
Special Benefits for Chapter Members:
Add information regarding any special benefits your chapters offers its members.
What the Chapter would like you to know:
Add any information you feel it is important for prospective members or others to know about your chapter. Could be your mission statement or your own personal statement.
Additional Comments:
Additional Comments

Would you like to be contacted about developing your own chapter website?
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