PEP University Chapter Application Form (Ontario)

University Chapter Application Form

Apply to open a new chapter of our organization at your university.
University Name
University Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Applicant Full Name

First NameLast Name
Applicant Position/Title at University
Applicant Email Address
example@example.com
Applicant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Why do you want to open a chapter at your university?
Does your university support the establishment of this chapter?
Describe your plans or proposed activities for the chapter.
How many students are interested in joining the chapter?