LMSA Northeast Chapter Information Update Form
Email address *
Chapter Information
School *
Full Name
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City, State *
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CHAPTER EMAIL *
*MUST HAVE*
Your answer
Name + Mobile number for chapter representative. *
The NE region has a chapter leader GroupMe. Please include the name + mobile number of the individual who should be included in the GroupMe.
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Chapter Leadership
President Name *
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President Email *
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Co-President Name
(if applicable)
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Co-President Email
(if applicable)
Your answer
VP Name *
Your answer
VP Email *
Your answer
Treasurer Name *
Your answer
Treasurer Email *
Your answer
Secretary Name *
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Secretary Email *
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Other positions (please include full position name, full individual name and email).
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Faculty Advisor(s)
Faculty Advisor Name *
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Faculty Advisor Title *
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Faculty Advisor Email *
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Faculty Advisor Phone Number *
Your answer
Questions/Comments/Concerns
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