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Member Society Application

Fields with a star (*) are required.

Formal Name of Society or Organization:(*)
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Mission statement/primary objective:(*)
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Approximate number of members:(*)
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Classes of Membership: (ex: fellow, trainee member, junior member, etc.)
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Membership in National or Multi-national bodies:
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Our organization is:(*)
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Description of the Society and its activities including total membership and field of endeavor in relation to the FOCIS mission(*)
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What are the benefits to applicant society and FOCIS membership(*)
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I certify that our Member Society Representative will write a summary of the pertinent points of the FOCIS annual meeting to share with our society.(*)
Required

 

President/Chair:

Name:(*)
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Designation:
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Title:(*)
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Address:(*)
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City:(*)
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State:(*)
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Zip/Postal Code:(*)
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Country:(*)
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Phone:(*)
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Fax:
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E-Mail:(*)
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Chief staff officer/main office contact:

Name:(*)
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Designation
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Title:
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Address:(*)
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City:(*)
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State:(*)
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Zip/Postal Code:(*)
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Country:(*)
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Phone:(*)
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Fax:
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E-Mail:(*)
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If your membership is approved, you will need to appoint a Member Society Representative. Please list their contact information below:

Name:(*)
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Designation:
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Title:
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Address:(*)
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City:(*)
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State:(*)
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Zip/Postal Code:(*)
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Country:(*)
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Phone:(*)
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Fax:
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E-Mail:(*)
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Upcoming meetings (name and date/year):

1:(*)
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2:
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3:
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4:
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Other future activities/educational programs (name and date):

1:(*)
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2:
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3:
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4:
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Recent Meeting History (date, location, number of attendees):

1:(*)
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2:
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3:
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Please attach as a Word or PDF document:

Roster of current officers, including address, telephone, fax and e-mail address (must be PDF):
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Copy of current Constitution and/or Bylaws (must be PDF):
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Letter of recommendation from FOCIS leader (must be PDF):
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FOCIS Steering Committee Letter of Sponsorship (must be PDF):
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(This leader can be a current or past FOCIS Chair, Vice Chair, Secretary/Treasurer, Committee Chair or Steering Committee Representative. For a list of FOCIS Leaders, please click here. )

*Note: This letter can also be sent via post to:

FOCIS Executive Office
N83 W13410 Leon Road
Menomonee Falls, WI 53051


If you need to make more attachments then space provides, please click here to send them as e-mail attachments. If you are attempting to upload files larger than 5 MB, please remove your attachments and click here to contact the FOCIS Executive Office. Please click only once. Your attachments may take a minute to upload.

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