ALDA Chapter Renewal Form

ALDA CHAPTER CHARTER RENEWAL FORM

This form needs to be completed and submitted in order to request that ALDA, Inc. renew the petitioners' ALDA Chapter Charter.

ALDA wants to make the annual Chapter Charter renewal as simple as possible. Simply complete the information below and be certain to click on SUBMIT at the bottom of the page when complete. This form is required to be filed under ALDA, Inc. to renew the petitioners' ALDA Chapter Charter. Thank you for your continued support of our ALDA family and for all you do to make a difference
- Given our desire to be of further service to people who are late-deafened and/or with hearing loss, and our desire to continue to promote ALDA, Inc., we hereby request ALDA, Inc. to renew our Chapter Charter for the coming year.
- When our Chapter Charter is renewed, we pledge to continue to pursue one or more of the objectives of ALDA, Inc. during the year ahead.
- Any circumstances that may prevent or hold the Chapter Charter status, we readily agree to remain connected to resolve any outstanding issues.
- We attest that we are over 18 years old; that we are members in good standing of ALDA, Inc, with our dues paid up-to-date; and that we will serve as the designated officers of our Chapter during the coming year.
We take great pride in our ALDA Chapters and welcome your thoughts and feedback. Stay connected, stay empowered with the ALDA motto to communicate anyway possible - Whatever Works!
Name of Chapter:*
Date*
MM slash DD slash YYYY
Please provide contact information for the petitioner who will serve as PRESIDENT of our ALDA Chapter during the coming year.
President's Name*
First Last
Address*
Street Address City State ZIP Code
Phone
Email*
Please provide contact information for the person who will serve as VICE PRESIDENT of your ALDA Chapter during the coming year.
Vice President's Name*
First Last
Address*
Street Address City State ZIP Code
Phone
Email
Please provide contact information for the person who will serve as SECRETARY of the requested ALDA Chapter.
Secretary's Name*
First Last
Address*
Street Address City State ZIP Code
Phone
Email*
Please provide contact information for the person who will serve as TREASURER of your ALDA Chapter during the coming year.
Treasurer's Name*
First Last
Address*
Street Address City State ZIP Code
Phone
Email*
Please provide the following additional information concerning your Chapter:
Number of members in your Chapter:*
Does your Chapter have a newsletter?*
- Yes
- No
Does your Chapter have a brochure?*
- Yes
- No
Does your Chapter have a website?*
- Yes
- No
If your Chapter has a website, what is the website address (URL)?
Please list any social media profiles (Facebook, Twitter, Instagram, LinkedIn, etc.)
How often does your Chapter meet?*
- Monthly
- Bimonthly
- Occasionally
Brief Summary of Past Group Activities:*

ALDA CHAPTER CHARTER RENEWAL FORM

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