Chapter Formation
Application
CHAPTER NAME:
CHAPTER CHAIR:
CHAPTER TREASURER:
CHAPTER FOUNDING MEMBERS (Must be KNA members and total at least 7)
CHAPTER DESCRIPTION (Briefly describe the purpose of the Chapter)
CHAPTER CONTACT PHONE:
CHAPTER CONTACT EMAIL:
CHAPTER CONTACT MAILING ADDRESS
REQUEST FOR CHAPTER FORMATION/START-UP FUNDS:
“Start-up” funding is limited to $500 and will automatically be approved for any approved chapter who requests the funds to
assist with the formation of the chapter. If you wish to request “start-up” funds, please indicate whether there is a chapter bank
account in which those funds are to be deposited or if the chapter prefers to have KNA handle the chapter’s funds and issues
checks/payments as needed. No payments will be made to individuals.
____ The chapter requests that $500 be deposited in the chapter bank account. The account
information is:
Bank:
Account Number:
Approved Signators for Account:
____ The chapter requests that the KNA house the start-up funds and make payments as needed on the
chapter’s behalf.