NPHC COUNCIL ROSTER OUTLINE

NPHC COUNCIL ROSTER OUTLINE

Please fill out the form as completely. All emails and phone numbers must be entered. Please put N/A where needed. ***NEW CHARTER/REACTIVATING COUNCILS: DO NOT COMPLETE THIS FORM UNTIL INSTRUCTED TO DO SO...IF YOU HAVE NOT REACHED OUT THE THE AREA COORDINATOR AND/OR ALUMNI or COLLEGIATE CHAIR PLEASE SPEAK TO THEM BEFORE COMPLETING THIS FORM***
Have you been instructed to complete this form by your Area Coordinator and/or the Alumni or Collegiate Chair
Council Status
Council Type
Number (#) of Chapters in Your Council
Date Submitting

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
For Fiscal Year?
Name of Person Completing Form

First NameLast Name
Title of Person Completing Form
Email of Person Completing Form
Phone Number of Person Completing Form
Select Council Preferred Time Zone
NPHC Area
NPHC Council Name (i.e. Inland Empire of California, No Abbreviations, include state)
Spell out full name of council
Council Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Council Website Address
Council List-Serve Address
This is the link to subscribe to Mailchimp, Constant Contact, etc.
Council Passdown Email Address
This should be a general council email (i.e. gmail.com, outlook.com, etc.) that is passed down after each term. If you do not have one please create one.
Council Correspondence Email Address
This should be a general council email (i.e. gmail.com, outlook.com, etc.) that is passed down after each term. If you do not have one please create one.
(Collegiate Council Only) NPHC Campus-Based Advisor Name
Person Employed by the University to advise the council
(Collegiate Council Only) NPHC Campus-Based Advisor Email
(Collegiate Council Only) NPHC Campus-Based Advisor Phone Number
Employed by the University to advise the council
Term Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Term End Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Next Election Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

COUNCIL OFFICER INFORMATION (ALL FIELDS MUST BE COMPLETED)

Rows	NAME	ORGANIZATION	CHAPTER	EMAIL	PHONE
PRESIDENT
VICE PRESIDENT
RECORDING SECRETARY
CORRESPONDING SECRETARY
TREASURER
FINANCIAL SECRETARY
PARLIAMENTARIAN
SERGEANT-AT-ARMS
CHAPLAIN
OTHER EXECUTIVE BOARD MEMBER
OTHER EXECUTIVE BOARD MEMBER
OTHER EXECUTIVE BOARD MEMBER
OTHER EXECUTIVE BOARD MEMBER
OTHER EXECUTIVE BOARD MEMBER

MEMBER CHAPTER DELEGATE/REPRESENTATIVE INFORMATION (ALL FIELDS MUST BE COMPLETED)
MEMBER CHAPTER PRESIDENT INFORMATION (ALL FIELDS MUST BE COMPLETED)
This form must be completed in its entirety. Please explain an N/As
Should be Empty: