EmailMeForm
BNI Houston East Member Status Report
Please submit this form when a member needs to be removed from your Chapter Roster.
Chapter Name:
*
Please select
Business Referral Partners of Pearland
Elite Networkers
First Class Referrals
Humble Business Alliance
Master Business Alliance
Premier
Referral Masters
Strategic Alliance
Winner's Circle
Your Name
*
First
Last
Report Submitted By
*
Please select
Secretary/Treasurer
Vice President
Membership Committee
Chapter Director
Regional Office
Your Email Address
*
Dropped Member Information
Name of member being dropped from roster
*
First
Last
Type of drop
*
Resignation (Member voluntarily resigned)
Termination (Membership Committee opened classification with Director approval)
Reason for drop (Why did the member resign or why were they terminated?)
*
Please select
Left company
Changed job
Relocated
Lack of referrals
Personal reasons
Scheduling conflicts
Did not renew
Transferred BNI Chapters
Terminated - MSP not completed
Terminated - Attendance
Terminated - Code of Ethics
Terminated - Participation
Chapter decided to deny renewal
Other - see notes below
Additional Information:
Effective Drop Date
*
MM
/
DD
/
YYYY
Enter the date the member notified the chapter of their resignation OR date in which the chapter terminated* the membership.
* Requires prior approval from BNI Director
If the member submitted a resignation letter please copy/paste in the space below: