Chapter Report Form – AFCC – WISCONSIN CHAPTER

Date of this Report

Calendar Year Covered by this Report

Name of Chapter President *

First

Last

1 - If required, has your Chapter filed its corporate annual report with the state or province?

2 - Has your Chapter filed its annual state or provincial and federal tax return?

3 - Is your Chapter in compliance with federal and/or other requirements to maintain your 501c(3) tax exempt status?

Is you answered No to Questions 1, 2, or 3, please explain. (indicate which Question) *

Please identify any special Chapter initiatives over this reporting period.

Please list any specific Chapter concerns.

Please describe what your members have received for their dues this year.

How often, and by what means, do you communicate with your membership?

Contact Info for Person Completing this Form *

First

Last

Address *

Address Line 1

City

State

Zip Code

Email *