AMS Chapter Data collection form
For academic year 2019-20

Those completing the form are asked to supply their email address to begin.
Email address *
Chapter Name *
Officer 1
Officer title (1) *
(fill in if "other" is selected)
Your answer
Term of office (begin) *
MM
/
DD
/
YYYY
Term of office (end) *
MM
/
DD
/
YYYY
First name *
Your answer
Last name *
Your answer
Email *
Your answer
Officer 2
Officer title (2) *
(fill in if "other" is selected)
Your answer
Term of office (begin) *
MM
/
DD
/
YYYY
Term of office (end) *
MM
/
DD
/
YYYY
First name *
Your answer
Last name *
Your answer
email *
Your answer
Officer 3 (if necessary)
Officer title (3)
(fill in if "other" is selected)
Your answer
Term of office (begin)
MM
/
DD
/
YYYY
Term of office (end)
MM
/
DD
/
YYYY
First name
Your answer
Last name
Your answer
email
Your answer
Officer 4 (if necessary)
Officer title (4)
(fill in if "other" is selected)
Your answer
Term of office (begin)
MM
/
DD
/
YYYY
Term of office (end)
MM
/
DD
/
YYYY
First name
Your answer
Last name
Your answer
email
Your answer
AMS Council representative (regular)
Term runs from 1 August in year one to 31 July in year 3 of term
Term (year one to year three, yyyy-yyyy) *
Your answer
First name *
Your answer
Last name *
Your answer
email *
Your answer
Two AMS Council representatives (student)
Term 8/12018-7/31/2020
First name *
Your answer
Last name *
Your answer
email *
Your answer
Term 8/1/2019-7/31/2021
First name *
Your answer
Last name *
Your answer
email *
Your answer
Thank you for completing the form! Use this space to communicate any additional comments, questions, adjustments, or concerns.
Your answer
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