Chapter Leadership Team Form
In-Coming Chapter Leadership Team: 2025-2026 Term
Please FULLY complete the following form:
Only members who are willing to complete the online BNI Business Builder role training and attend the September Leadership Team Summit may serve on the Leadership Team. Please fill out all the Leadership Team roles a submit one time.
Chapter Name
*
Submitted By
*
First Name
Last Name
Your Cell Number
*
Please enter a valid phone number.
Your Email
*
Has your Leadership Team been APPROVED by your BNI Area Director?
*
Yes
No
President
First Name
Last Name
President Email
President Cell Phone Number
Vice President
First Name
Last Name
VP Email
VP Cell Phone Number
Secretary/Treasurer
First Name
Last Name
Sec/Treas Email
Sec/Treas Cell Phone Number
MC - Quality Assurance
First Name
Last Name
QA Email
QA Cell Phone Number
MC - Community Builder
First Name
Last Name
CB Email
CB Cell Phone Number
MC - Member Engagement
First Name
Last Name
ME Email
ME Cell Phone Number
MC - Member Relations
First Name
Last Name
MR Email
MR Cell Phone Number
Mentor Coordinator
First Name
Last Name
Mentor Email
Mentor Cell Phone Number
Visitor Host Coordinator
First Name
Last Name
VHC Email
VHC Cell Phone Number
Visitor Host 1
First Name
Last Name
VH1 Email
VH1 Cell Phone Number
Visitor Host 2
First Name
Last Name
VH2 Email
VH2 Cell Phone Number
Visitor Host 3
First Name
Last Name
VH3 Email
VH3 Cell Phone Number
Visitor Host 4
First Name
Last Name
VH4 Email
VH4 Cell Phone Number
Visitor Host 5
First Name
Last Name
VH5 Email
VH5 Cell Phone Number
Visitor Host 6
First Name
Last Name
VH6 Email
VH6 Cell Phone Number
Education Coordinator
First Name
Last Name
EC Email
EC Cell Phone Number
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