Chapter Charter Petition (continued)

 

Please provide the petitioner's name (PRINT, please) and signature. The signatures of at least ten (10) members in good standing are required. Additional signatures are welcome and additional sheets may be used. Please be certain that the first name listed is that of the Designated Contact or Chapter Chairperson Elect and include a phone number for the new chapter contact.

 

Petitioner (Print)Signature

 

1. ______________________________________________________________________

2. ______________________________________________________________________

3. ______________________________________________________________________

4. ______________________________________________________________________

5. ______________________________________________________________________

6. ______________________________________________________________________

7. _____________________________________________________________________

8. _____________________________________________________________________

9. ______________________________________________________________________

10. _____________________________________________________________________

 

I hereby concur in this petiton and recommend to the Board of Directors that a chapter charter be granted as requested.

 

Headquarters ApprovalBoard ApprovalYes ___ No ___

 

 

___________________________________________________________________

Executive DirectorDateChairperson Board of DirectorsDate