<p> ALABAMA A&M UNIVERSITY ALUMNI ASSOCIATION, INCORPORATED MEMBERSHIP ROSTER COVER SHEET 2012 CHAPTER NAME: ______</p><p>CHAPTER MAILING ADDRESS: ______</p><p>CITY ______STATE ______ZIP ______</p><p>TELEPHONE NUMBER ( ) ______TAX ID NUMBER______</p><p>Financial Secretary______E-mail Address ______Treasurer ______E-mail Address ______</p><p>FINANCIAL INFORMATION No. of Members Total ACTIVE MEMBER ______@$50 $______</p><p>LIFE MEMBERSHIP ______</p><p>NEW LIFE MEMBERSHIP Maroon and White Member ______@$500 $______</p><p>Silver Member ______@$1,000 $______</p><p>Gold Member ______@$5,000 $______</p><p>ASSOCIATE MEMBER ______@$20 $______</p><p>CORPORATE MEMBERSHIP Maroon and White ______@$300 $______</p><p>Diamond ______@$500 $______</p><p>Executive Diamond ______@$1,000 $______</p><p>MEMBERSHIP TOTALS ______$______</p><p>CHAPTER TAX ($25.00 minimum per year) $______</p><p>CHARTER FEE ($50.00 new chapter fee) if applicable $______</p><p>CONTRIBUTIONS: 1875 Normalite Campaign ($1000 minimum per chapter) $______Legislative Reception ($250 minimum per chapter) $______</p><p>TOTAL THIS REPORT $______Page 2 Membership Roster Cover Sheet </p><p>Please list the names of known deceased Normalites (January 2011-December 2011).</p><p>Name Provide Dates /Class Year If Known</p><p>1. ______</p><p>2. ______</p><p>3. ______</p><p>4. ______</p><p>______Chapter President Signature</p><p>______Mailing Address</p><p>______City State Zip Code</p><p>______Telephone Number</p><p>______E-mail Address ALABAMA A&M UNIVERSITY ALUMNI ASSOCIATION, INCORPORATED</p><p>CHAPTER ANNUAL REPORT 2012</p><p>NAME OF CHAPTER ______</p><p>OFFICERS</p><p>PRESIDENT ______Name </p><p>______Mailing Address</p><p>______City State Zip Code</p><p>______Telephone Number</p><p>______E-mail Address Class Year</p><p>VICE PRESIDENT ______Name </p><p>______Mailing Address</p><p>______City State Zip Code</p><p>______Telephone Number</p><p>______E-mail Address Class Year Page 2 – CHAPTER ANNUAL REPORT</p><p>RECORDING SECRETARY______Name </p><p>______Mailing Address</p><p>______City State Zip Code</p><p>______Telephone Number</p><p>______E-mail Address Class Year</p><p>FINANCIAL SECRETARY______Name </p><p>______Mailing Address</p><p>______City State Zip Code</p><p>______Telephone Number</p><p>______E-mail Address Class Year Page 3 – CHAPTER ANNUAL REPORT</p><p>TREASURER ______Name </p><p>______Mailing Address</p><p>______City State Zip Code</p><p>______Telephone Number</p><p>______E-mail Address Class Year</p><p>PARLIAMENTARIAN ______Name </p><p>______Mailing Address</p><p>______City State Zip Code</p><p>______Telephone Number</p><p>______E-mail Address Class Year Page 4 – CHAPTER ANNUAL REPORT</p><p>HIISTORIAN______Name </p><p>______Mailing Address</p><p>______City State Zip Code</p><p>______Telephone Number</p><p>______E-mail Address Class Year</p><p>CHAPLAIN ______Name </p><p>______Mailing Address</p><p>______City State Zip Code</p><p>______Telephone Number</p><p>______E-mail Address Class Year</p><p>NAMES AND CATEGORY OF NEW MEMBERS:</p><p>1.______CATEGORY______</p><p>2.______CATEGORY______</p><p>3.______CATEGORY______Page 5 – CHAPTER ANNUAL REPORT</p><p>PLEASE INDICATE NUMBER OF MEMBERS IN THE FOLLOWING CATEGORIES</p><p>NEW MEMBERS ______</p><p>LIFE MEMBERS ______</p><p>ACTIVE ______</p><p>ASSOCIATE ______</p><p>HONORARY ______</p><p>DATE(S) OF REGULAR MEETING(S)</p><p>______</p><p>______</p><p>SCHOLARSHIPS TOTAL AMOUNT OF SCHOLARSHIP FUND ______NUMBER OF SCHOLARSHIPS AWARDED ______TOTAL AMOUNT AWARDED ______</p><p>CONTRIBUTIONS TO ALABAMA A&M UNIVERSITY (BE SPECIFIC)</p><p>1.______</p><p>2.______</p><p>3.______</p><p>4.______</p><p>5.______</p><p>6.______</p><p>7.______Page 6 – CHAPTER ANNUAL REPORT</p><p>SIGNIFICANT ACTIVITIES (BE SPECIFIC)</p><p>1.______</p><p>2.______</p><p>3.______</p><p>4.______</p><p>5.______</p><p>6.______</p><p>7.______</p><p>PROBLEMS/CONCERNS</p><p>______</p><p>______</p><p>Report Submitted By</p><p>______Name/Signature</p><p>______Office</p><p>______Date ALABAMA A&M UNIVERSITY ALUMNI ASSOCIATION, INCORPORATED</p><p>CHAPTER FINANCIAL STATEMENT YEAR ENDING DECEMBER 31, 2011</p><p>Name of Chapter ______</p><p>Submitted by: President ______Signature</p><p>Treasurer______Signature Date Approved by Chapter: ______Cash Balance: January 1, 2011 $______Cash Receipts for the Year: $______Membership Dues $______National ______Local ______Life Membership Maroon ______Silver ______Gold ______Income from Events $______Raffle $______Special Fundraising Events (please list) $______</p><p>Interest Income $______Other Receipts $______Total Receipts $______Cash Disbursements for the Year: General Operation Fund $______Cost of Fundraising Events $______Postage, Printing, and Supplies $______Normalite Legal Defense Fund $______Contribution to Alabama A&M University $ ______Chapter Tax (By-law change 9/04 - $ 25.00 minimum) Charter Fee ($50.00) $ ______1875 Normalite Campaign $______(By-law change 9/04 -$ 1, 000.00 minimum) Legislative Reception (By-law change 9/04 - $ 250.00 minimum) $ ______Scholarship $______Other Costs $______</p><p>Total Disbursements $______</p><p>Cash Balance: December 31, 200___ $______Stocks, CD’s, Other Holdings $______</p><p>Total Assets $______NATIONAL MEMBERSHIP ROSTER Alabama Agricultural and Mechanical University Alumni Association, Incorporated</p><p>______Chapter Name</p><p>LIFE MEMBERS</p><p>Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______NATIONAL MEMBERSHIP ROSTER Alabama Agricultural and Mechanical University Alumni Association, Incorporated</p><p>______Chapter Name</p><p>ACTIVE MEMBERS ($50)</p><p>Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Major ______Class Year ______</p><p>NATIONAL MEMBERSHIP ROSTER Alabama Agricultural and Mechanical University Alumni Association, Incorporated</p><p>______Chapter Name</p><p>ASSOCIATE MEMBERS ($20)</p><p>Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______Name ______Address ______City/State/Zip ______Home Phone ______Cell Phone ______Email Address ______</p>