Intention to Form a State Chapter

 

I have read the NACPM State Chapter Launch Packet/Agreement and hereby affirm that it is my state’s intention to proceed with creating an NACPM State Chapter. By completing this form, I confirm that I am a current NACPM member and I agree to serve as the primary point of contact/state liaison for coordinating my state’s application process with NACPM. I will let NACPM staff know if/when this responsibility transitions to someone else in my state. I also give permission to NACPM to share my contact information to those interested in our State Chapter activities.