Chapter Associations Information Form

Fields market with (*) are required

Area Number (*)

Is this chapter being dissolved? (*)
—Please choose an option—YesNo

Is this a new chapter? (*)
—Please choose an option—YesNo

Chapter Name (*)

Chapter City(*)

Meeting City (*) (If city varies enter "Rotates")

Meeting Date/Time (Ex: 3rd Tuesday of each month at 6:00 pm)

Primary Contact (*)

Phone (*)

Email (*)

Chapter Website

Meeting Address
(If applicable)

Social Media
(Ex: Facebook, Linkedin, etc.)

About Our Chapter
(Ex: Mission, Goals, etc.)

Additional Information

Downloadable Files
(Ex: Chapter membership application, meeting schedule, etc.)
File types allowed: PDF, DOC, DOCX, JPG.

File 1
Limit 800kb

File 2
Limit 800kb

File 3
Limit 800kb