EmailMe Form - NBA Section Certification Form

Section Certification Form
(See NBA Constitution, Article VIII, Section 3.D and NBA By-Laws Chapter VII, Section 3.
This is to certify that the following section or division met on the following day for its annual meeting and the following person, who is a regular member of the Association, was elected chairperson and will present the Section and/or Division on the NBA Board of Governors.
Section Name
Name/Newly-Elected Chairperson *
First Last
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email *
Office Number *
### - ### - ####
Home Number *
### - ### - ####
Does your Section manage funds through a separate bank account? *
Account Number
If yes, please provide name(s) of banks and locations; If you do not manage funds through a seperate account, please reply with "NONE" or "N/A"
Name *
First Last
Section/Division Office *
Date *
MM / DD / YYYY
Name *
First Last
Section/Division Office *
Date *
MM / DD / YYYY
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