Federation of Texas A&M University Mothers' Club Electronic Submission Form C Please note: The directory can only list three officers; if your Club has co-positions, choose one to be the primary office holder for publication in the Federation directory. CLUB INFORMATION Club Name —Please choose an option—AbileneAlvinAmarilloAngelina CountyArizonaAtascosa CountyAustinAustin CountyBandera CountyBastrop CountyBaytownBeaumontBee CountyBi-StoneBlanco CountyBosque CountyBrazoria CountyBrazos CountyBrush CountryBurleson CountyCentral TexasClear Lake AreaCoastal BendColeman CountyCollin CountyComal CountyCoppellCorpus ChristiDallas CountyDeep East TexasDel RioDenton CountyDenver, ColoradoDeWitt-LavacaEagle PassEast Bell CountyEl Campo AreaEl PasoEllis CountyFort Bend CountyFort Worth/Tarrant CountyFriendswood AreaGalveston CountyGrayson CountyGuadalupe CountyHarrison CountyHays CountyHeart of TexasHenderson CountyHighland LakesHill CountryHill CountyHood AreaHopkins County AreaHoustonJohnson CountyKaty/West HoustonKaufman CountyKendall CountyKerrville AreaKingwood/HumbleLaredoLiberty CountyLone StarLouisianaLubbock AreaMatagorda CountyMedina CountyMid-Jefferson CountyMidlandMilam CountyMinnesota and West WisconsinMontgomery CountyNacogdoches CountyNavarro CountyNortheast Tarrant CountyNorthwest Harris CountyOrange CountyPanola CountyParker CountyPasadena AreaPearlandPikes PeakRandolph AreaRio Grande ValleyRockwall CountyRound Rock AreaRusk CountySan AngeloSan AntonioSandstormShelby CountySouthwest Dallas CountyStephenville AreaTri-CountyTylerTyler CountyUvalde AreaVictoria CountyWaco-McLennan CountyWalker CountyWashington CountyWest Bell CountyWichita County AreaWilliamson CountyWilson CountyWise CountyWood County List cities or counties represented by current membership (required) # of full paid members, including Life Members (required) # Associate Members # Adopt-a-Mom Members Club Email (required) Website Facebook Officer Election Date (required) if manually entering the date, use format yyyy-mm-dd Outgoing President Name (required) Telephone (required) Complete the next fields if your Club has a permanent address Street Address City (required) State —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip INCOMING PRESIDENT'S INFORMATION First Name (required) Last Name (required) Street Address (required) City (required) State —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip (required) Telephone (required) President's Email (required) The President's address will be published in the Federation directory. Choose which address to publish on Federation website: Use Club's permanent addressUse President's address Choose your preferred method of notification of amendments to the bylaws: via emailvia USPS mail INCOMING TREASURER'S INFORMATION First Name (required) Last Name (required) Street Address (required) City (required) State —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip (required) Telephone (required) Email (required) ADDITIONAL OFFICER INFORMATION Incoming MembershipIncoming Boutique First Name (required) Last Name (required) Street Address (required) City (required) State —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip (required) Telephone (required) Email (required) MEETING INFORMATION Time (required) Day of Month (required) Meeting Location (required) Street Address (required) City (required) State —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip (required) FORM C SUBMISSION Form C Submitted by (required) Incoming PresidentOutgoing President Email (required) Additional Comments Form C Submission