Current Chapter Officers and Programs
Use this form to report changes in your officers' list including new officers, address, phone changes, effective dates, etc. This information will be used to generate mailing labels and the Chapter Roster. The roster is distributed two (2) times each year with Chapter Topics. Please also list the Chapter's annual conference program, contact person, location and date as well as your newsletter editor and legislative liaison. You may fax this form to (312) 280-2520 when it is completed.
| CHAPTER NAME: | DATE OFFICERS CHANGE: |
| CHAIR: | VICE CHAIR: |
| Title & Institution Address: | Title & Institution Address: |
| Phone: | Phone: |
| Fax: | Fax: |
| E-Mail: | E-Mail: |
| NEWSLETTER EDITOR: | CHAPTER PROGRAM: |
| Name: | Title or Theme: |
| Title & Institution Address: | |
| Date: | |
| Location: | |
| Contact Person: | |
| Address: | |
| Phone: | Phone: |
| Fax: | Fax: |
| E-Mail: | E-mail: |
| LEGISLATIVE LIAISON: | |
| Name: | Institution Address: |
| Title: | |
| Phone/Fax: | |
| E-mail: | |
| CHAPTER'S WEBSITE ADDRESS: | |