Please complete this form to submit your new chapter information and your first three required events for the coming six months.

Chapter Name*

Chapter Mission Statement*

Contact Email*

President Name*

Vice President Name*

Marketing Chair Name

Event Chair Name

Notes

Event 1 Name*

Event 1 Date*

Event 1 Time*

Event 1 Address*

Event 1 Address Line 2

Event 1 City*

Event 1 State*

Event 1 ZIP*

Event 1 Country*

Event 1 Activity*

Event 1 Estimated Cost*

Event 2 Name*

Event 2 Date*

Event 2 Time*

Event 2 Address*

Event 2 Address Line 2

Event 2 City*

Event 2 State*

Event 2 ZIP*

Event 2 Country*

Event 2 Activity*

Event 2 Estimated Cost*

Event 3 Name*

Event 3 Date*

Event 3 Time*

Event 3 Address*

Event 3 Address Line 2

Event 3 City*

Event 3 State*

Event 3 ZIP*

Event 3 Country*

Event 3 Activity*

Event 3 Estimated Cost*