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 or visit the website at
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Today's date *
Name of chapter organizer: *
Proposed chapter name: *
Street Address *
City *
State or Province *
Zip or Postal Code: *
Country *
Telephone *
Email *
Website *
Meeting Schedule *
If other, specify:
Meeting location: *
Meeting Venue *
If roving, list 1st meeting venue.
Meeting address *
If roving, list 1st meeting address
Meeting time *
If roving, list 1st meeting time
Additional comments:
Rules and details of operations *
I agree to operate this chapter in adherence to the rules and details set forth at
Is this a chapter renewal? *
Is this an update of info to an existing chapter?
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How did you hear about Barley's Angels?
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