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.
Council Status

Existing Council (Select if in existence prior to June 30, 2024)New Charter/Reactivating Council (Select IF NOT in existence prior to June 30, 2024)
Council Type

Alumni CouncilCollegiate Council
Date Submitting*

MonthDayYear
Date
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
Date
Term End Date*

MonthDayYear
Date
Next Election Date*

MonthDayYear
Date

COUNCIL OFFICER INFORMATION (ALL FIELDS MUST BE COMPLETED)*

	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: