Intention to Form a State Chapter

I have read the NACPM Chapter Launch Packet/Agreement and hereby affirm that it is my state/territory/jurisdiction’s intention to proceed with creating an NACPM 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 chapter’s application process with NACPM. I will let NACPM staff know if/when this responsibility transitions to someone else in my state/territory/jurisdiction. I also give permission to NACPM to share my contact information to those interested in our Chapter’s activities.