Change Your Chapter Info

Change or Update of Information Form

Fill out the form below

Step 1

Step 2

Step 3

Step 4

Step 5

Step 6

Please use this form to change contact information for the chapter councilor, co-councilor, and their supervisors.

Current Institution Name * Chapter Greek Name * Submitter's Email Address *

I Need to Update/Change * Chapter Councilor Name/Address/Phone/Fax/EmailChapter Councilor Supervisor Name/Phone/EmailCo-Councilor Name/Phone/EmailCo-Councilor Supervisor Name/Phone/EmailInstitution Name/Address

You do not need to complete this step

You can continue to step 4.

Chapter Councilor

The primary contact for the ASLHS chapter.

Is the new Chapter Councilor a current ASLHS member? * NoYes First Name * Last Name * Position Title & Department * Institution Street Address * City * State * Zip Code * Work Email * Work Phone * Work Fax Who is the Councilor replacing? * Who does this person report to? * Position Title & Department * Work Email * Work Phone *

You do not need to complete this step

You can continue to step 5.

Co-Councilor

The co-councilor will be listed in our online directory as an alternate contact for ASLHS chapter communications. This person will also be copied on all correspondence sent to the ASLHS chapter councilor.

Does you chapter have a Co-Councilor? * NoYes

Full Name Position Title & Department Email Address Phone Number Who does this person report to? Position Title & Department Work Email Work Phone

You do not need to complete this step

You can continue to step 6.

Institution

Please fill in the fields below.

Current Institution Name * New Institution Name (if applicable) Institution Street Address * City * State * Zip Code * Work Email *

Date * Signature *