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Chapter Supplies Request

Services Offered to Chapters from the Executive Office

To support Chapter activities the Executive Office currently offers the following services to assist you with your projects and dessimination of the goals and mission of the parent organization. Please fill out the form below to submit your request for supplies. Requests may be made up to twice annually and will be shipped using the most economical means possible (please note: this may cause lengthy delivery for those outside of the US).

Delivery Information
Name of Chapter/Contact:
Address Line 1 :
Address Line 2 :
City:
State or Province:
Zip/Postal Code:
Country:
Email:

Please send our Chapter a package of...
	Recycled SCB pens (15)	Conference leftovers (if available, t-shirts, bags, etc.)
	Annual reports (15)	Sample CIP issues (5)
	Available brochures
	Sample CB issues (1)

We would like to request use of the Chapters banner for the duration of:
Please specify the date you would like the Chapters banner mailed and the date you will return it.
Mail date:		Return Date:

Special requests

If your Chapter has need of additional supplies for larger events or has special requests for marketing materials please specify your needs below. We will contact you with additional information.

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