Chapter Data Report - Fall
DUE NOVEMBER 1 ANNUALLY
Chapter Information
Official Chapter Name:
AHS Region:
Click to select your region from the dropdown list.
Mid Atlantic Region (Delaware, DC, Maryland, New Jersey, Pennsylvania, Virginia, West Virginia)
Mid Central Region (Indiana, Kentucky, Michigan, Ohio)
Northeastern Region (Connecticut, Eastern Canada, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont)
North Central Region (Illinois, Iowa, Minnesota, Missouri, North Dakota, South Dakota, Wisconsin)
Pacific Region (Alaska, British Columbia, California, Hawaii, Oregon, Washington)
Southeastern Region (Florida, Georgia, North Carolina, South Carolina, Puerto Rico, Brazil)
Southern Region (Alabama, Arkansas, Louisiana, Mississippi, Tennessee)
South Central Region (Kansas, Nebraska, Oklahoma, Texas)
Western Region (Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming)
Mid Atlantic Region (Delaware, DC, Maryland, New Jersey, Pennsylvania, Virginia, West Virginia)
Chapter Website:
(or enter "None")
Chapter Facebook page:
Chapter Email Address (if applicable):
Number of members currently in Chapter:
Membership Categories (Adult, Student, etc.)
Annual Chapter Dues Amount(s):
Does your chapter have any questions/concerns?
Current Officers
Note: Officers must be national members of AHS, Inc. to be listed on the website.
President
President Email
Vice-President
Vice President Email
Secretary
Secretary Email
Treasurer
Treasurer Email
Other Officers (Titles. Names and Emails)
Officer elections were held on (date):
MM
/
DD
/
YYYY
President's (or best chapter contact's) name, phone number AND email:
Name
Email
Phone
Does this person give their permission to have their contact information listed in the Membership Directory and on the Chapters page on harpsociety.org?
In the Directory:
Both Email and Phone
Email Only
Phone Only
No, please do not list.
On AHS website Chapters page:
Both Email and Phone
Email Only
Phone Only
No, please do not list.
Report submitted by:
Same as President/best chapter contact above
Other - please provide (fields will appear):
Name
Phone
Email to receive submission confirmation
(May be edited)
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