QUARTERLY MEMBERSHIP REPORT

CFDD Chapter of:  
#
For Period Ending:
(Indicate One)
Mar 31  (Due Apr 10)
Jun 30  (Due Jul 10)
Sep 30  (Due Oct 10)
Dec 31  (Due Jan 10)
  (Paid Membership for Next Fiscal Year)
Membership Awards will be based on Dec 31st Report. That report must be received by Jan 10th.
A. CHAPTER MEMBERSHIP RECAP (Please complete)
Active:
 Interim:
Honorary:
Student:
TOTAL:
If you do not pay for Honorary Members, do not include in Section “B” total below.
Do not include Student Membership in Section “B” total below.
B. CHAPTER MEMBERSHIP REPORTED FOR NACM RECORD:
Total Reported Previous Quarter:
** Members Gained:
** Members Lost:
Net – (Gain or Loss)
Total Paid Membership Reported
This Quarter
** Record all gains, losses, changes on standard forms and mail with Executive Director’s copy
C. AFFILIATE MEMBERSHIP
(Did Your Chapter Obtain New Members for NACM?)
NACM Affiliate Members Obtained
This Quarter
** NACM Affiliate Members Obtained
This Year to Date
** Note: Is this your Dec. 31 report?
If so – have your Affiliate Chief Operating Officer or Affiliate Chairman of the Board, sign here to confirm the figures on Affiliate Memberships secured by your chapter.
Name:
Date:
D. YOUR COMMENTS ON MEMBERSHIP ACTIVITY:
Signed by:
Your e-mail address:
Title:
Date:
(mm/dd/yyyy)

A PENALTY OF $1.00 PER MEMBER WILL BE ASSESSED IF QUARTERLY MEMBERSHIP REPORT IS NOT RECEIVED, IN EXECUTIVE DIRECTOR’S OFFICE, BY THE 25TH OF THE REPORTING MONTH.
   
Carol Fowle, CCE
Executive Director
NACM-CFDD
8840 Columbia 100 Parkway
Columbia, MD 21045