Application for Recognition of
Student Chapter
(Please print clearly or type)
Name of Proposed Student Chapter:
Educational/Research Institutions Associated with this Chapter:
Mission of Student Chapter:
Name of Faculty Advisor:
CHAPTER CORRESPONDANCE
Individual to whom correspondence should be addressed:
Street Address of Student Chapter:
City, State, Postal Code, Country:
Phone:
Email:
QUESTIONNAIRE:
Please complete the following information for application approval.
1. Initial number of individuals interested in joining the chapter:
2. Desirable number of chapter members:
3. Does the chapter plan to charge membership dues, and if yes, what is the amount?
4. Is there an existing CRS Chapter or has there ever been a chapter associated with the
institutions this chapter will be associated with?
If yes, please list. Note that CRS staff will be in contact to review the application in further detail.
ATTACHMENTS:
Please include as attachments to this application:
1. Contact details of the minimum 10 individuals interested in becoming members of this
chapter, indicating those who will serve in leadership positions
2. Chapter Bylaws/Constitution
CHAPTER AGREEMENT
Membership
 It is understood that individuals leading the chapter by acting on the chapter’s board or
leadership council (i.e. President, Vice-President, Chair, Treasurer, Secretary) must maintain
current membership in CRS.
 It is understood that the Faculty Advisor position must be held by a full-time faculty member of
the associated institution, and that individual must maintain current CRS membership.

It is understood that upon application, the prospective chapter must have of a minimum of 10
individual members of the Student Chapter (this includes chapter leadership). One year from
becoming an approved CRS Student Chapter, the chapter must maintain a minimum of 15
members of the Student Chapter.
Chapter Obligations
 It is understood that the chapter will communicate chapter activities and information to CRS,
promote CRS membership, promote the CRS Annual Meeting, contribute to the annual meeting,
submit an annual report, and actively pursue key performance indicators (KPIs) as outlined in
the CRS Chapter Policy & Procedure Manual.
Funding
 It is understood that after CRS officially recognizes this student chapter, the chapter may
request up to $500 (to be dispersed in two parts) for startup funds.
Adherence to Chapter Policy & Procedure Manual
 By signing this agreement, the chapter agrees to adhere to the terms of the CRS Chapter Policy
& Procedure Manual to remain in good standing as a chapter of CRS.
I, on behalf of the student chapter of ______________________________ hereby request recognition
of the aforementioned chapter and agree to abide by the International Affiliation Agreement and I
understand that:
i.
The chapter will be solely responsible for all debts and obligations incurred by the chapter or
arising in the course of its activities.
ii.
The chapter will operate in a dignified and professional manner and bring no discredit to the
Controlled Release Society name and to the society itself.
iii.
The Controlled Release Society reserves the unilateral right to terminate and withdraw the
authority of the chapter to utilize Controlled Release Society name and logo, for any reason.
iv.
The chapter will notify the Controlled Release Society in writing upon dissolution of the chapter.
On behalf of:
___________________________________
(Name of Chapter)
_____________________________________
(Name of Student)
___________________________________
(Signature of Student)
___________________________________
(Date)
___________________________________
(Name of Faculty Advisor)
______________________________________
(Signature of Faculty Advisory)