Scrapbook Contest Evaluation Form

National FFA Alumni Association [email protected] Application for Local FFA Alumni Charter 317-802-4292

Application for 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 be chartered as an affiliate of the FFA Alumni Association.

We are attaching to this application: 1) purposes or proposed constitution and bylaws under which we desire to operate in harmony with the (state)/National FFA Alumni constitution; 2) 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 3) the names of our executive group with a designated president. Our FFA Alumni Council is as follows:

President: Name Telephone Number

Street Address City State Zip Vice President: Name Telephone Number

Street Address City State Zip

Secretary: Name Telephone Number

Street Address City State Zip Treasurer: Name Telephone Number

Street Address City State Zip Other: Name Telephone Number

Street Address City State Zip FFA Advisor: Name Telephone Number

School Name Address

City State Zip Email

If granted a charter, 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

4/5/2018 1 alum_as National FFA Alumni Association [email protected] Application for Local FFA Alumni Charter 317-802-4292

4/5/2018 2 alum_as