Chapter Leader Form

FALA Chapter

Candidate Name

First Name Last Name

Phone Number *

Area Code Phone Number

E-mail *

example@example.com

Facility/Company Name *

Facility/Company Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Is your facility/company a FALA member in good standing*? *

Yes No

Are you a Facility member or an Associate member?

Facility Member Associate Member

*Only FALA members in good standing may serve as Chapter leaders.

Is your facility part of a multi-facility corporation? (Associate members may skip this question)

Yes No

How many chapter meetings have you attended in the past 24 months?

Please see Chapter Leader position descriptions below:

Chair-

Must be an ALF Administrator or AFCH Provider of a FALA Member Facility
Coordinate and lead Chapter leadership meetings and calls
Lead monthly Chapter meetings
Assist Secretary in securing pertinent monthly speakers
Assist Membership Chair in explaining benefits and building both ALF/AFCH and association membership

Vice Chair or Co-Chair-

Same duties as Chair

Secretary-

Schedule monthly meeting locations for the year
Communicate meeting schedule to FALA office using form that is included in this manual
Communicate schedule to local senior calendars and other partners
Schedule pertinent speakers (with help of Chair and Vice Chair)
Create meeting agenda (with help of Chair)
Take meeting notes
Maintain meeting Sign In Sheets (See example form)
Maintain meeting records including continuing education

Treasurer-

Collect meeting fees as outlined in the cost section of manual
- Have another member of the chapter leadership verify funds prior to end of meeting.
Make bank deposit within 3 days of meeting and report to FALA Office.
Provide a treasury report at each business meeting of the chapter

Legislative Chair (Could be held by another officer)-

Coordinate activities with FALA Director of Government Affairs
Serve as lead for any PAC fundraising events
Schedule visits with local legislators
Coordinate local participation in annual Legislative Days

Membership Chair (could be held by another officer)-

Verify membership status of chapter meeting registrants
Coordinate activities with FALA Director of Membership
Serve as lead for Chapter membership initiatives
Educate local ALF communities and AFCH providers about benefits of FALA membership
Provide membership application forms and information at each chapter meeting or event
Plan and coordinate local membership drive efforts and special events

Special Events Chair-

Coordinate activities with FALA Director of Operations
Serve as lead for Special Events Committee
Plan and coordinate special events (i.e., cruises, mini conferences, holiday parties, etc.)

Please indicate the Chapter position you seek:

Chair Vice Chair Treasurer Secretary Membership Chair Legislative Chair Special Events Chair

Serving as a Chapter leader requires a commitment of time. Are you willing and able to make this commitment?

Yes No

Are you willing to participate in Committees if applicable to Chapter position? Ie. if you are appointed as Membership Chair, you would participate in the FALA Membership Committee.

Yes No

Why do you want to serve as a FALA Chapter leader?

Candidate Filing Form for Chapter Leader Positions