New Chapter Application Form

New Chapter Application Form
As part of the Chapter Application, we will ask for the following documents to upload:
- A roster of your elected officers or governing body
- Constitution, bylaws, or other governing documents
- Resolution
Other required documents:
- ICC Members list
- Other chapter members
- Participating chapters (for regional chapters only)
For more information on what is needed to apply, as well as sample documents, visit the chapters webpage.
Name of Organization: *
Primary Contact Name*

First NameLast Name
Primary Contact Email*
example@example.com
Primary Contact Phone*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please provide your web page address, if applicable.
Desired Chapter Status:*

Code Official/GovernmentalRegional ChapterState ChapterLocal (Area) ChapterProfessionalStudentGlobal
Meetings (please provide the month or actual date and location, if known):
When is your annual meeting?
When is your election/installation of officers?
How often does your board meet?
How often does your membership meet?

What year was your organization first established?
Primary Discipline

BuildingElectricalFireMechanicalPermit TechnicianPlumbingProperty MaintenanceZoningOther
If you have no primary discipline, please describe the professional background of your members.
Please describe the geographical area served by your organization.
Provide a statement of purpose.
ICC Members List*

Provide a list of names, addresses, and ICC member numbers (if known) of individuals within your organization for the required number of memberships necessary to meet the minimum requirements of Section 4.0 of the Council Policy 10.
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Other Chapter Members

Provide the name, affiliation, title, address, phone number and e-mail address of all other chapter members in electronic format.
Cancelof

FOR REGIONAL CHAPTERS ONLY
Participating Chapters:*

Provide a list of all ICC chapters in the region.
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FOR STUDENT CHAPTERS ONLY
Academic Institution:*
Provide the name and address of the academic institution.
Faculty Advisor

First NameLast Name
Please provide a statement of purpose.

Elected Officers or Governing Body Roster*

Provide a roster of all elected officers including name, title, employer, address, city, state/province, zip code, country, phone number, e-mail address and terms they are serving.
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Constitution/Bylaws or Other Governing Documents*

Provide a copy of your current constitution and/or bylaws, memorandum of understanding or other governing documents.
Cancelof
Resolution:*

Submit a resolution from the ICC chapter sponsoring your group.
Cancelof
Other Information:

Submit any other information applicable to this application or provided by an existing chapter in support of the applicant.
Cancelof
Should be Empty: