Chapter Information Form
Please fill out your information below. This will allow us to contact you directly to assist with new chapter requirements and important information.
Chapter Name
Chapter Email Address
*
example@example.com
Chapter Type
Please Select
Student
Professional
Combined (professionals & students)
Chapter Region
Please Select
Northeast
Southeast
Midwest
West
Southwest
Does the chapter use NOBCChE's EIN?
Please Select
Yes
No
Link to chapter social media or handle
Chapter Status
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Active
Dormant
Inactive
Potential Chapter
Chapter Officer Information
Chapter Advisor
*
First Name
Last Name
Advisor Email
*
example@example.com
Chapter President
*
First Name
Last Name
President Email
*
example@example.com
Chapter Treasurer
*
First Name
Last Name
Treasurer Email
*
example@example.com
Chapter Recorder
*
First Name
Last Name
Recorder Email
*
example@example.com
Please add additional advisors or other important information here.
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