ALDA GROUP CHARTER RENEWAL FORM This form needs to be completed and submitted in order to request that ALDA, Inc. renew the petitioners' ALDA Group Charter. ALDA wants to make the annual Group 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 Group Charter. Thank you for your continued support of our ALDA family and 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 Group Charter for the coming year. When our Group 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 Group 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 leaders of our Group 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 Group:* Date?* MM slash DD slash YYYY Please provide contact information for the petitioner who will serve as LEADER of your ALDA Group during the coming year.Leader's Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail* Please provide contact information for a second petitioner who will be a MEMBER of your ALDA Group during the coming year.Member Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail* Member Title Please provide contact information for a third petitioner who will be a MEMBER of your ALDA Group during the coming year. Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail* Member Title Please provide the following additional information concerning your Group.Number of members in your Group?* Does your Group have a newsletter?* Yes No Does your Group have a brochure?* Yes No Does your Group have a website?* Yes No If your Group has a website, what is the website address (URL)? Please list any social media profiles (Facebook, Twitter, Instagram, LinkedIn, etc.)How often does your Group meet?* Monthly Bimonthly Occasionally Brief Summary of Past Group Activities:*