EAPA Chapter/Branch Webpage Update Form

Please complete all data fields that require updating on your chapter/branch webpage. Fields marked with * are required. When done, simply click on "Submit" at the bottom of the form.

1. Submitter Name*

First NameLast Name

2. Submitter Title*

3. Submitter Email*

4. Chapter/Branch*

5. What geographic area is served by you chapter/branch? (i.e. cities, counties, part o state, etc.)*

6. Permanent chapter/branch contact information (address, phone, fax and/or email):*

7. Do you usually have your chapter/branch meetings at the same location?

Yes - answer quetions 8 and 9.No - skip questions 8 and 9. When you answer question 10, provide locations for scheduled meetings.

8. Location/address where your chapter/branch meets:

9. Directions to your chapter/branch meeting location:

10. List your chapter/branch meeting dates/times (i.e. X monthly meetings per year, 3rd Tuesday of every month, from 8:30-11:00 am, etc.)

11. Cost to attend your meetings for EAPA members:

12. Cost to attend your meetings for non-members:

13. Please provide your upcoming meeting schedule:

14. Name, phone number and email address of your chapter/branch president:

15. Name, phone number and email address of your chapter/branch vice president:

16. Name, phone number and email address of your chapter/branch treasurer:

17. Name, phone number and email address of your chapter/branch secretary:

18. Name, title, phone number and email address of the person who is in charge of your chapter/branch membership recruitment:

19. Name, title, phone number and email address of the person who is in charge of your chapter/branch educational programs:

20. If you have a chapter/branch website, please provide the URL:

21. If you have any other chapter/branch information on the Internet that you would like us to link to, please provide the relevant URLs:

If you have comments, requests or any other chapter/branch documents that you would like us to post, please email them to webeditor@eapassn.org.