Language English Español Português U.S. Chapter Leader Questionnaire Your Contact InformationPlease review your contact information and make any updates needed.First Name(Required)Last Name(Required)Email(Required) Phone(Required)Address(Required)City(Required)State(Required)Select StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonMarylandMassachusettsMichiganMinnesotaMississippiMissouriPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip(Required)Chapter Leadership InformationAccording to our records, you are currently serving in the role and chapter below.RoleChapterAre you willing to continue serving in the role and chapter provided above?(Required) Yes No Is there someone else serving in this role currently, or is there someone you would recommend?(Required) Yes No What is the name of the person currently serving or who you're recommending?(Required)If you can provide it, what is their email address? If you can provide it, what is their phone number?Chapter Activity InformationThe following questions are about the activity and governance of your chapter listed above.To your knowledge, has your chapter held any meetings or other activities in 2023 or so far in 2024?(Required) Yes No To your knowledge, has your chapter ever created a charter, bylaws, or other governing document for the chapter? This would include policies and proceedures for choosing chapter leadership.(Required) Yes No Are you able to share this governing document(s) for your with the Executive Committee?(Required) Yes No Please upload the governing document(s) for your chapter to share them with the Executive Committee.(Required) Drop files here or Select files Accepted file types: doc, docx, pdf, Max. file size: 512 MB. Your Concerns and SuggestionsPlease share concerns or suggestions you may have with the Executive Committee regarding chapter development and support. Please share any thoughts about your experience as a leader for your chapter.This field is hidden when viewing the formContact SFIDThis field is hidden when viewing the formChapter SFIDThis field is hidden when viewing the formEmail Campaign ID Δ
