Counselors for Social Justice University Chapter Annual Report
DEADLINE: September 30

IMPORTANT: THIS FORM CANNOT BE SAVED
We recommend you review the application content and make sure that you have all information prepared to complete the application.

For any questions, email Membership@counseling-csj.org

Email address *
Updating Chapter Information
Chapter CSJ organization name *
Your answer
Chapter Website
Your answer
Chapter Facebook page
Your answer
Chapter Twitter account
Your answer
Chapter Additional Social Media
Your answer
We will share your CSJ chapter name, website, email and social media, and contact person's name and email address on our CSJ national website. If you do NOT want this shared, please indicate here
Contact Person
Typically the chapter president or faculty advisor
Contact Person Name *
Your answer
Contact Person Address *
Your answer
Contact Person Email Address *
Your answer
Contact Person Phone Number *
Your answer
Contact Person University *
Your answer
Contact Person Title or Role *
Your answer
Chapter Info
Officer Titles and Names *
Titles should match your constitution
Your answer
Current Number of Members *
We recommend at least 5 to start a chapter
Your answer
Have you arranged a bank account? *
Areas of Emphasis Available Through Program *
e.g., School Counseling, Clinical Mental Health Counseling
Your answer
Areas of Emphasis Available Through Program
e.g., School Counseling, Clinical Mental Health Counseling
Your answer
Degree Programs Available (if applicable)
e.g., School Counseling, Clinical Mental Health Counseling
If Masters, Number of Hours
Your answer
Faculty Advisors
Faculty Advisor Information Name *
Your answer
Faculty Advisor Title *
Your answer
Confirm Faculty Advisor is a CSJ Member *
Faculty ACA or CSJ Membership Number *
Your answer
Faculty Advisor Email Address *
Your answer
Faculty Advisor Phone Number *
Your answer
When do you plan to hold meetings? *
At least 2 per year
Your answer
Please acknowledge the following and submit any updates to Membership@counseling-csj.org
Do you have updates to your Chapter Agreement? *
Do you have updates to your Chapter Constitution? *
Annual Report
Annual Planning: What are your goals for the coming year and how do you plan to accomplish these goals? For example: Goal 1 is to increase chapter membership so we will hold two membership meetings per semester; Goal 2 is to increase student engagement in advocacy so we will offer an advocacy training via webinar. *
Your answer
Past Year Summary: (1) What were you main accomplishments over the past year? (2) What challenges did you encounter (if any)? *
Your answer
Support: How can the CSJ national organization support you in these goals?
Your answer
Thank You!
NEXT STEPS: The Membership Committee will review your Annual Report to renew your affiliation. You will be notified of approval or requests for changes via the contact person's email address. Typically, the review process takes no more than 30 days.
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