EmailMeForm
BNI Rochester - Member Status Report
This form provides notification to the Regional Office of roster changes. Please use one form per membership change.
Today's Date
*
MM
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DD
/
YYYY
Chapter Name
*
Report Submitted By
*
Please select
Secretary/Treasurer
Vice President
Membership Committee
Chapter Director
Regional Office
Your Name
*
First
Last
Your Email Address
*
There are three ways a member is to be removed from the chapter membership roster.
1. The member resigns their membership or chooses not to renew.
2. The Membership Committee terminates the membership.*
3. The Membership Committee declines the member's renewal.*
*Requires Director Approval
Member's Name
*
First
Last
1. Member RESIGNED for the following reason:
Select if Applicable
Changed job
Did not renew
Left company
MSP not completed
No reason given
Lack of referrals
Not right fit with company
Personal reasons
Relocated
Scheduling conflicts
Takes too much time
Transferred BNI Chapters
This allows the Regional Office to track the reason members have left the organization.
2. Membership Committee TERMINATED the membership for the following reason:
Select if Applicable
Attendance
Code of Ethics
Participation
*DIRECTOR APPROVAL REQUIRED prior to submitting this report and notifying the member. The appropriate BNI Accountability Letter must also be sent to the member upon obtaining Director approval.
3. Membership Committee DENIED RENEWAL for the following reason(s):
Lack of Participation
Lack of Referral Given
Lack of Visitors Invited
Other (provided addtional details below)
* DIRECTOR APPROVAL REQUIRED prior to submitting this report and notifying the member. The appropriate BNI Accountability Letter must also be sent to the member.
Additional Information:
Effective Date of Member's Drop:
*
MM
/
DD
/
YYYY
Enter the date the member notified the chapter of their resignation OR date in which the chapter terminated* the membership.
