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Officer Address Information Form - Mortar Board

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Officer Address Information Form - Mortar Board Powered By Docstoc
					Please complete and email to reports@mortarboard.org by May 15 or following officer elections.
College/University Office                                Officer description (if    Primary chapter   First name   Last name
                                                         applicable)                mailing address

                   Advisor - senior                                                       Yes
                   Advisor - junior
                   Advisor - sophomore
                   Administrative liaison
                   President
                   Conference delegate (usually president)
                   Vice President
                   Secretary
                   Treasurer
                   Membership chairperson
                   Historian
                   Director of communications
                   Alumni relations
                   Fundraising chair
                   Social chair
                   Service/Philanthropy chair
                   Web/Technology chair
                   Additional officer                          (please describe)
                   Additional officer                          (please describe)
                   Additional officer                          (please describe)
                   Additional officer                          (please describe)
                   Additional officer                          (please describe)
                   Additional officer                          (please describe)
                   Additional officer                          (please describe)
                   Additional officer                          (please describe)
                   Additional officer                          (please describe)
                   Additional officer                          (please describe)
                   Additional officer                          (please describe)
                   Primary chapter mailing address (if not that of an officer)
Primary e-mail   Alternate e-mail   Address   Address line 2 (if   City   State   ZIP   Phone
address          address                      necessary)
Chapter e-mail (if applicable -   Chapter Web site (if applicable - only type once)
only type once)

				
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