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NSBE Chapter Visit Request
Chapter Visit Request
Name*:
Location*:
Chapter Leadership Position, if any*:
Phone Number*:
(
)
-
Second part
Third part
Email address*:
Geographical Region*:
Region I
Region II
Region III
Region IV
Region V
Region VI
Choose up to 5 potential visitors (use "ctrl" for multiple selections)*:
National Chair
National Vice Chair
National Secretary
National Treasurer
National Programs Chair
National Parliamentarian
National Chair Emeritus
National Publications Chair
National Public Relations Chair
National Communications Chair
National Finance Chair
National Financial Controller
2011 Convention Planning Committee Chair
National Academic Excellence Chair
Business Diversity Chair
Leadership Institute Chair
Pre-College Initiative Chair
National Membership Chair
Region I Chair
Region II Chair
Region III Chair
Region IV Chair
Region V Chair
Region VI Chair
International Committee Chairperson
Dates Requested (list top 3 dates):
1):
Date and time
2):
Date and time
3):
Date and time
Would you classify your chapter as*:
Very Strong
Alive & Well
Struggling
Dead
What is the main reason you are requesting a chapter visit AND how would a visit from a NSBE leader address your chapter's needs?:
What are the 3 greatest strengths of your chapter:
What are your chapter's 3 greatest challenges or weaknesses?:
How would you rate your NSBE chapter in the following areas? (Consider 1 as not successful and 5 as masters of this area.)
Member Recruitment*:
1
2
3
4
5
Member Participation*:
1
2
3
4
5
Choosing programs*:
1
2
3
4
5
Implementing programming:
1
2
3
4
5
Fundraising*:
1
2
3
4
5
Getting members to Regional & National meetings*:
1
2
3
4
5
Comments:
Please list below the programs your chapter currently offers.*:
What new programs, projects, or campaigns do you wish to pursue this year?*:
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