APPENDIX A SAMPLE FORMS
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BPW / TN Record Maintenance Form
Please copy this form, as needed, to send to BPW / TN.
Member’ s Name __________________________________________________________ Local Organization Name / ID:______________________________________________
Please Circle the Type of Information to be Changed: NAME ADDRESS PHONE MEMBERSHIP STATUS MEMBERSHIP TYPE OFFICER ASSIGNMENT LOCAL AFFILIATION EMAIL ADDRESS
Please record the information to be changed: ______________________________________________________________________________
______________________________________________________________________________ ______________________________________________________________________________
Please record the information, as it should now be listed / List reason for change, if applicable: ______________________________________________________________________________
______________________________________________________________________________ ______________________________________________________________________________
SEND TO: |
BPW / TN |
Route to: |
|
Record Maintenance |
Treasurer |
|
718 Thompson Lane Suite # 108-323 |
Membership Chair |
|
Nashville, TN 37204 |
Regional Director Publication Editor( Address Changes) |
QUESTIONS? CONTACT BPW / TN by E-mail at info @ bpwtn. com Name of Member Submitting Form:
____________________________________________ Daytime Phone Number:(_____) _________________ E-mail: ________________________
63 June 2011