Please use this form for quarterly reporting. You must report at least once a year to retain affiliation. Reports may be submitted anytime during the quarter, but, if items are to be included in the “Chapter Coordinator’s Column” of the 10-10 News they are due by the 25th of February, May, August, and November.

Quarterly Report

Section 1:

Chapter Identificaiton (All items in this section require input).

Section 2:

Chapter Head (CH) Information. (Input necessary only to reflect changes).

Section 3:

Certificate Manager (CM) Information. (Input necessary only to reflect changes).

Section 4:

Correspondent (CR) Information. (Input necessary only to reflect changes).

Chapter Net Infromation:  (Input necessary only to reflect changes)

The information on this form is used to update the "Chapters Net Guide and/or "10-10 Chapter" information on the 10-10 website, http://www.ten-ten.org. Therefore any additional information that may be of interest should be sent to the Chapter Coordinator.

I certify that this form is accurate.

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