Fillable Chapter Visit Request Form 2019-2021 (North Carolina DKG)

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Chapter Visit Request Form 2019-2021 (North Carolina DKG)

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The Chapter Visit Request Form 2019-2021 (North Carolina DKG) form is 1 page long and contains:

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  • 11 check-boxes
  • 25 other fields

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File type: PDF

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Chapter Visit Request Form 2019-2021
Date____________________________
Chapter/s Requesting Visit _________________________________ Region _____________________
Chapter President_______________________________________ Preferred #_____________________
Address__________________________________________________________________________________
City ____________________________________________ State __________ Zip _____________________
Cell # ___________________________________ Email __________________________________________
Contact Name (if other than president)________________________________________________________
Address___________________________________________________________________________________
City ____________________________________________ State __________ Zip _____________________
Cell # ___________________________________ Email ___________________________________________
Meeting Date, Time, Location: Please provide all requested information.
First Choice ________________________________________________________________________________
Second Choice______________________________________________________________________________
Third Choice________________________________________________________________________________
Officer will be
⬜ Guest
⬜ Presenter, topic:___________________________________________________________________________
⬜ Conducting Chapter Ceremony (Member Induction, Officer Installation, etc.)
⬜ Attending Birthday Celebration _________Year
⬜ Other____________________________________________________________________________________
If state president is not available would you like another state officer to visit? ⬜ Yes ⬜ No
Did your chapter request a visit from the state president last year? ⬜ Yes ⬜ No
Did your chapter receive a visit from a state officer or regional director last year? ⬜ Yes ⬜ No
If so, please list officers –________________________________________________________________________
Send request to Dr. Teresa H. Cowan, NC DKG President
cowan2019eta@gmail.com or 26 Wolf Rd., Asheville, NC 28805
Maintain a copy for your records.
NC DKG Chapter Visit Request Form (05/29/2019)
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Chapter Visit Request Form 2019-2021 (North Carolina DKG)

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Completed 13 February 2021

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