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XX  _  X !߻   ii5%!`z `Ett iii5%!`z `Ett i (#(#      (#(#X6X߻CHAPTERREPORTTOREGION *  REPORTFORFISCALYEAR:July1,______toJune30,_____CHAPTER   Name:InstituteNumber:MailingAddress:DateChartered:Incorporated?Yes/NoLiabilityInsurance?Yes/NoBUSINESSOFFICE : Location:Telephone:Fax:Duties/Responsibilities:OtherHiredServices:Cost:MEETINGS J BoardMeetingtime,day,location:Attendance:ChapterMeetingtime,day,location:AverageChapterMeetingattendance:(%oftotalmembership):MealCost:Includedindues?Yes/NoProgramssincelastreport:Mostsuccessfulprogram(s):Leastsuccessfulprogram(s):Specialmeeting(s)/program(s):#߻XX6#X6X߻ -(, uuMEMBERSHIP x  DateofReport:Professional:Industry:Associate:Retired:Honorary:Student:Emeritus:Other:Total:Membershipactivities(recruiting,orientation,retention,etc):FINANCIAL t  AnnualDuesProfessional:$Industry:$Associate:$Retired:$Honorary:$Student:$Emeritus:$Other:$Duesincreaseanticipated?0  Explain: (#(# FundRaisers:PleaseattachTreasurersReports/FinancialStatementsandChapterBudgetformostrecentmonthandforfiscalyearendingpreviousJune30.OFFICERS 4$ (EnternamesforthoseelectedbyyourChapterforfiscalyearendingpreviousJune30)President:PresidentElect:VicePresident:SecondVicePresident:Secretary:Treasurer:Secretary/Treasurer:Directors: l-#' COMMITTEES x  (CheckthosemaintainedbyyourChapter)ArrangementsAuditAwardsBudgetandFinanceBylawsCertificationCommunicationsEducationHistorianHost(forInstituteorRegionevent)LiaisonMembershipNominatingPlanningProgramsPublicationsTechnicalTelephoneTradeShowOtherCOMMITTEEACTIVITIES 4 Pleaseattachsummariesofmajoraccomplishmentsforeachcommitteeduringthepastyear.IncludeincomeandexpensedetailsforTradeShowsandSeminars.Indicatespecialplansfornextyear.NEWSLETTER H# Distribution:AnnualCost:AdvertisingSupport:AdvertisingRates:AWARDS (X" AttachlistofChapterAwardspresentedtomembersRegionAwardsacceptedbychapter/members:InstituteAwardsacceptedbychapter/members: l-#' ЇREGION/INSTITUTESUPPORT/ACTIVITY x  MembersattendingRegionConference:Chaptersupport:$MembersattendingInstituteConvention:Chaptersupport:$MembersattendingInstituteLeadershipEvent:Chaptersupport:$Other:Chaptersupport:$MembersservingRegion(listindividualandtitle)Committees:Other:MembersservingInstitute(listindividualandtitle)Officers:Committees:Other:ANALYSISOFSTRENGTHS&WEAKNESSESANDSUGGESTIONSFOR H IMPROVEMENT 4 AttachwrittenstatementPREPAREDBY:DATE:#߻XX6# \"  X6X߻REGIONAWARDS * FORMD1NOMINATIONLETTER   h           `     h   <(  hp x (#X< Date______________   H.` hp x (# XHTo:  SouthwestRegion,CSIAwardsCommittee b     ______________________  InstituteDirector  ______________________ X______________________ XFrom:  ______________________ :   (Chapter)(_Individual[s_])(Others)<(  hp x (#X<Weherebynominate _________________________________________________, Professional  Member)(IndustryMember)(AssociateMember)(Firm)(Organization) forthe  ___________________________________Awardtorecognizethefollowingaccomplishments: X XB( ` hp x  XB __________________________________________________________________ f _____________________________________________________________________________________________________________________________ . >  X?+ ` hp x (#X?  .~   XB.` hp x (#XBEvidenceofqualificationsofthenomineeisattached,alongwithbiographicalstatistics.________________________President(Signature)________________________Secretary(Signature)Enclosures#߻XX6#