Scrapbook Contest Evaluation Form s1

Application for Update of Local Charter

We, , Council President, and , Council Secretary, acting as officers of the organization known as FFA Alumni, an organization for past, active, collegiate and honorary FFA members, and present and former professional agricultural educators, and other individuals interested in supporting agricultural education, having at present (#) members and acting for this organization, do hereby make application to update our charter as an affiliate of the FFA Alumni Association.

We are attaching to this application: 1) a list of at least ten members who have paid (state)/National dues and / or the names and addresses of (#) new members and payment of $ to cover the cost of their dues; and 2) the names of our executive group with a designated president. Our FFA Alumni Council is as follows:

President: Name Telephone Number Email

Street Address City State Zip Vice President: Name Telephone Number Email

Street Address City State Zip

Secretary: Name Telephone Number Email

Street Address City State Zip Treasurer: Name Telephone Number Email

Street Address City State Zip Other: Name Telephone Number Email

Street Address City State Zip FFA Advisor: Name Email

School Name Address

City State Zip Email

We shall comply with the State and National Constitution and Bylaws of the FFA Alumni Association and work for the successes and purposes of the FFA Alumni Association.

We certify that the information given in this application and attachments hereto is true and correct.

______FFA Advisor Council President ______Date and Place Signed Council Secretary

of 2 New/Reactivating FFA Alumni Affiliate Profile Information Please complete the following information and return it with your chartering/reactivating documents (application for charter, bylaws, excel roster). Questions can be directed to [email protected]. FFA Alumni Affiliate Name:

Principle Office of the FFA Alumni Affiliate Mailing Address:

Affiliate City:

Affiliate State:

Affiliate Zip:

Affiliate email (if applicable):

Affiliate Main Contact Phone:

The FFA Alumni Serves the following Agricultural Education Programs/FFA Chapter(s): Note: If you serve a larger number of programs then space provided, please list additional chapters at the bottom of the form. FFA Chapter Name & City:

FFA Chapter Name & City:

Agricultural Career Network (AgCN) – Administrative Access Note: Please identify 2-4 local FFA Alumni leaders who will need administrative rights (Alumni Leader role) in AgCN, our online membership and affiliate management tool. Do NOT list the agricultural instructor as the system will grant them administrative rights to the Alumni roster automatically. These individuals will receive an email from national staff with an invitation to set up your personal AgCN account. Alumni Leader #1 Name:

Alumni Leader #1 Email:

Alumni Leader #2 Name: