NNOA Chapter Deactivation
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name of Chapter / Interest Group
*
Region
*
Central
Eastern
Western
Other
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Proposed Chapter/Interest Group Point of Contact (Include Service Affiliation)
*
POC Email Address
*
example@example.com
Click to Confirm Contact with the Regional VP
*
click here
Back
Next
Proposed Deactivated Chapter Name
Proposed Deactivation Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Summary of Active Members (Include Rank & Branch of Service) at Time of Dormancy
Chapter Status
Location of all Chapter Funds
Provide all Passwords to the Website and Social Media
Provide Supporting Material to Support Chapter Deactivation
Confirm Contact with National Secretary and National Treasurer
*
click here
Submit
Should be Empty: