Counselors for Social Justice University Chapter Annual Report
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.

If you have any questions, the CSJ Membership Committee can be reached at: Membership.CSJ@gmail.com.

Section 1 of 2: Updating Chapter Information
Chapter CSJ organization name: *
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Chapter CSJ organization email
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Chapter CSJ organization website
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Chapter CSJ Facebook page
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Chapter CSJ Twitter account
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Chapter CSJ Additional Social Media
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Contact Person Name (Typically the chapter president or faculty advisor): *
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Contact Person Address: *
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Contact Person Email Address *
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Contact Person Phone Number *
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Contact Person University Name: *
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Contact Person Title or Role *
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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:
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Officer Titles and Names (titles should match your constitution) *
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Current Number of Members (we recommend at least 5 to start a chapter) *
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Have you arranged a bank account? *
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Areas of Emphasis Available Through Program (e.g., School Counseling, Clinical Mental Health Counseling)
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Degree Programs Available (if applicable)
If Masters, Number of Hours
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Faculty Adviser Information Name: *
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Faculty Advisor Title: *
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Confirm Faculty Advisor is a CSJ Member (required) *
Faculty ACA or CSJ Membership Number: *
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Faculty Advisor Email Address: *
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Faculty Advisor Phone Number: *
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When do you plan to hold meetings (at least 2 per year)? *
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Do you have updates to your Chapter Agreement? (If yes, submit to Membership.CSJ@gmail.com with email subject line "CHAPTER UPDATE") *
Do you have updates to your Chapter Constitution (If yes, submit to Membership.CSJ@gmail.com with email subject line "CHAPTER UPDATE") *
Section 2 of 2: 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.
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Past Year Summary: (1) What were you main accomplishments over the past year? (2) What challenges did you encounter (if any)?
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Support: How can the CSJ national organization support you in these goals?
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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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