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Chapter Visit Request Form
Please complete this form to request a chapter visit from a national or regional NSBE leader.
Email address *
Email Address (this email will be used to contact you)
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Name (First, Last)
Your answer
NSBE leadership position (if any)
Your answer
Region
If your region is segmented into zones please provide the zone name.
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Chapter Name
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Visit Type
Please describe the greatest strengths, weaknesses, and immediate needs of your chapter.
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Please provide the name and position of leader being requested for visit.
Your answer
Please provide the reason for the request.
Your answer
What level of engagement and knowledge from the leader is needed?
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