Chapter Administrator Information Form

Use this form to report a new Chapter Administrator to Headquarters. A Chapter Administrator is the college administrative staff member who oversees the chapter for the college. This is the individual who appoints the chapter advisor/s.

Salutation

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First Name

Last Name

Area of Discipline

Title

College Name

Chapter Name

Mailing Address

City

State

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Zip

Phone

Email

Term Begin Date

Former Chapter Administrator's Name (If applicable)

Former Chapter Administrator's Term End Date (If applicable)