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2025 VAYD Chartering: Membership Roster
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Club Name:
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Chartering Contact Name:
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Chartering Contact Email:
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Chartering Contact Phone #:
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Date Submitting:
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Faculty/Staff Advisor:VAYD Constitution 11.5.vi requires a list of any and all faculty/staff advisors with current contact information for teen and college chapters.
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Email:
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Phone:
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Please fill out each line completely. Any record without required information will not count toward membership totals. Delete example record prior to submitting.
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ChapterFirst NameLast NamePhone NumberEmail AddressAddressCityStateZIPBirth date (MM/DD/YYYY)Officer Title (if applicable)Term Expires: (MM/DD/YYYY)
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AlexandriaCharnieleHerring703-606-9705
info@charnieleherring.com
123 First StAlexandriaVA223129/25/1969Delegate12/31/2021
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