Active Status Confirmation: Collegiate Chapter
Please submit by October 15th and retain a copy for your chapter's files.
Chapter Name
*
Region
*
1
2
3
4
Region Councilor Email
*
A copy of this form will be emailed to the Region Councilor.
Chapter E-mail
If applicable
Institution
*
College or University
Family & Consumer Sciences Unit
e.g., Human Ecology
Institution Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Highest Unit Administrator
*
Prefix
First Name
Last Name
Title
I. Current Officers for the 2023-2024 Academic Year
Please also ensure that officers are updated in GreekTrack by logging in at www.phiu.org.
President
First Name
Middle Name
Last Name
President Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
President Email
example@example.com
President Phone
-
Area Code
Phone Number
Vice-President
First Name
Middle Name
Last Name
Vice-President Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Vice-President Email
example@example.com
Vice-President Phone
-
Area Code
Phone Number
Treasurer
First Name
Middle Name
Last Name
Treasurer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Treasurer Email
example@example.com
Treasurer Phone
-
Area Code
Phone Number
Secretary
First Name
Middle Name
Last Name
Secretary Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Secretary Email
example@example.com
Secretary Phone
-
Area Code
Phone Number
Publicity Chair
First Name
Middle Name
Last Name
Publicity Chair Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Publicity Chair Email
example@example.com
Publicity Chair Phone
-
Area Code
Phone Number
II. Advisor Information
Chapter Advisor
*
Prefix
First Name
Middle Name
Last Name
Title
Chapter Advisor Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Chapter Advisor Email
*
A copy of this form will be emailed to the Chapter Advisor.
Chapter Advisor Phone
*
-
Area Code
Phone Number
Professional Program Advisor
Prefix
First Name
Middle Name
Last Name
Title
Professional Program Advisor Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Professional Program Advisor Email
example@example.com
Professional Program Advisor Phone
-
Area Code
Phone Number
Financial Advisor
Prefix
First Name
Middle Name
Last Name
Title
Financial Advisor Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Financial Advisor Email
example@example.com
Financial Advisor Phone
-
Area Code
Phone Number
III. Chapter Membership
Sophomores
Juniors
Seniors
Grad Students
Total
*
President's Signature
*
Advisor's Signature
*
Date
*
-
Month
-
Day
Year
Date
IV. Alumni Contact Information
Please attach a separate list of names and email addresses for members who have graduated in the past 1-5 years (for the purpose of inviting them to join the alumni chapters).
Attach List Here
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