Barley's Angels Chapter Application
When your application is approved and the $25 annual fee received, your chapter information will be added to the Barley's Angels website and you will be ready to go! Please note that the Chapter Organizer must be a woman.

If you have any questions, please contact Christine Jump at christine@barleysangels.org or visit the website at http://barleysangels.org.

Today's date *
Your answer
Name of chapter organizer: *
Your answer
Proposed chapter name: *
Your answer
Street Address *
Your answer
City *
Your answer
State or Province *
Your answer
Zip or Postal Code: *
Your answer
Country *
Your answer
Telephone *
Your answer
Email *
Your answer
Website *
Your answer
Meeting Schedule *
If other, specify:
Your answer
Meeting location: *
Meeting Venue *
If roving, list 1st meeting venue.
Your answer
Meeting address *
If roving, list 1st meeting address
Your answer
Meeting time *
If roving, list 1st meeting time
Your answer
Additional comments:
Your answer
Rules and details of operations *
I agree to operate this chapter in adherence to the rules and details set forth at http://barleysangels.org
Required
Is this a chapter renewal? *
Is this an update of info to an existing chapter?
How did you hear about Barley's Angels?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms