24-25 Region VI Chapter Executive Board Contact Information Form
Hello NSBE Leader, Thank you for taking the time to fill this form out! This information is needed so that the Region VI's Membership Zone can be able to contact you or a fellow chapter leader in the future.
Chapter/School Name (No Abbreviations)
*
What Zone is your Chapter in?
*
Pacific Northwest Zone: Washington, Oregon, Idaho, Montana, and Alaska
Northern California Zone: Northern & Central California (including Fresno & San Luis Obispo)
Southern California Zone: Southern California & Hawaii
Southwest Zone: Arizona, New Mexico & Nevada
Rocky Mountain Zone: Colorado, Utah, and Wyoming
International Zone: Western Canada, Baja Peninsula Mexico, Asia, South Pacific Australia
President's Name
*
First Name
Last Name
President's Email
*
example@example.com
President's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Vice President's Name
*
First Name
Last Name
Vice President's Email
*
example@example.com
Vice President's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Secretary's Name
*
First Name
Last Name
Secretary's Email
*
example@example.com
Secretary's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Treasurer's Name
*
First Name
Last Name
Treasurer's Email
*
example@example.com
Treasurer's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Programs Chair Name
*
First Name
Last Name
Programs Chair Email
*
example@example.com
Programs Chair Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Membership Chair Name
*
First Name
Last Name
Membership Email
*
example@example.com
Membership Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Senator/Delegate 1 Name
*
First Name
Last Name
Senator/Delegate 1 Email
*
example@example.com
Senator/Delegate 1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Senator/Delegate 2 Name
First Name
Last Name
Senator/Delegate 2 Email
example@example.com
Senator/Delegate 2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Public Relations Chair Name
*
First Name
Last Name
Public Relations Chair Email
*
example@example.com
Public Relations Chair Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Outreach/TORCH Chair Name
*
First Name
Last Name
Outreach/TORCH Chair Email
*
example@example.com
Outreach/TORCH Chair Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
PCI Chair Name
*
First Name
Last Name
PCI Chair Email
*
example@example.com
PCI Chair Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Academic Excellence Chair Name
*
First Name
Last Name
Academic Excellence Chair Email
*
example@example.com
Academic Excellence Chair Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Chapter Advisor Name
*
First Name
Last Name
Chapter Advisor Email
*
example@example.com
Chapter Advisor Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Chapter Email
*
example@example.com
Chapter Website
*
Do you have additional board members? If so, fill out the following prompts
Position
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Position
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Position
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Position
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Position
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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