NCCU Alumni Association, Inc.                             Local Chapter Information Form
Every NCCU Alumni Chapter is required to complete this form by July 1 of each year.  Write N/A if the position is vacant.
President's First and Last Name *
President's Email *
President's Phone number *
President's Address *
Vice President's First and Last Name *
Vice President's Email *
Vice President's Phone Number *
Vice President's Address *
Secretary's First and Last Name *
Secretary's Email *
Secretary's Phone Number *
Secretary's Address *
Treasurer's First and Last Name *
Treasurer's Email *
Treasurer's Phone Number *
Treasurer's Address *
Parliamentarian's First and Last Name *
Parliamentarian's Email *
Parliamentarian's Phone Number *
Parliamentarian's Address *
Membership Chair's First and Last Name *
Membership Chair's Email *
Membership Chair's Phone Number *
Membership Chair's Address *
Student Recruiter's First and Last  Name *
Student Recruiter's Email *
Student Recruiter's Phone Number *
Student Recruiter's Address *
Council Representative's Name *
This individual is responsible for attending the National Alumni Association meetings and is empowered to represent the chapter at the meetings.  The individual must be in good standing with the NCCU Alumni Association, Inc.  
Council Representative's Email *
Council Representative's Phone Number *
Council Representative's Address *
Chapter Mailing Address *
Chapter Email *
Chapter Website *
Annual Chapter Dues *
Chapter Meeting Schedule (Include Place & Time) *
Meeting Time *
Total Number of Members *
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