Section and Chapter Officer Report Form

STUDENT CHAPTER OFFICER REPORT FORM

Bylaws for The Wildlife Society, its Sections, Chapters, and Student Chapters require for all elected officers and advisors to be members of The Wildlife Society (parent society). After each election and any other change in officers (within 20 days), please fill out this form (typed, not hand-written) and submit it to The Wildlife Society, 425 Barlow Place, Suite 200, Bethesda, MD 20814 or via fax (301) 530-2471 or via email to Mariah Simmons at .

Please change titles, or copy and paste extra “boxes”, if needed.

To join The Wildlife Society (parent society), you may apply online or download the membership application at http://wildlife.org/join/ or call our office at 301-897-9770 ext 316.

Please type officer information, do NOT write.

Student Chapter Name Election Date

MM/DD/YYYY

Student Chapter Permanent Address AND/OR Email Address (if applicable)

President

Name / Office Term Dates / MM/DD/YYYY-MM/DD/YYYY
Address
Cell Phone / Email

President-Elect (aka Vice President)

Name / Office Term Dates / MM/DD/YYYY-MM/DD/YYYY
Address
Cell Phone / Email

Chapter Representative (if applicable)

Name / Office Term Dates / MM/DD/YYYY-MM/DD/YYYY
Address
Cell Phone / Email

Secretary

Name / Office Term Dates / MM/DD/YYYY-MM/DD/YYYY
Address
Cell Phone / Email

Treasurer

Name / Office Term Dates / MM/DD/YYYY-MM/DD/YYYY
Address
Cell Phone / Email

TWS Liaison

Name / Office Term Dates / MM/DD/YYYY-MM/DD/YYYY
Address
Cell Phone / Email

Student Chapter Advisor

Name / Office Term Dates / MM/DD/YYYY-MM/DD/YYYY
Address
Cell Phone / Email

Include other officer positions, if necessary (see second page)…

[Include additional elected positions here, i.e. Board Members, Committee Chairs, etc.]

Name / Office Term Dates / MM/DD/YYYY-MM/DD/YYYY
Address
Cell Phone / Email

[Include additional elected positions here, i.e. Board Members, Committee Chairs, etc.]