INTERNATIONAL READING ASSOCIATION STATE AND PROVINCIAL COUNCIL OFFICERS REPORT FORM 2013-14

Form Login Account (Optional)

New Users/Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partically complete this form and return later to finish the form. The account you establish is only for this form.

IRA relies on an accurate and complete Officers Report Form to ensure effective communication with your council's leadership team throughout the year. The Officer Report Form also provides important legal information regarding council functioning and organizational management. It is strongly sugggested that the IRA State/Provincial Coordinator complete the Officer Report Form, as he/she is your official liaison with IRA.

Important Requirements for State and Provincial Councils to Remain Active:

* The Officer Report Form needs to be completed between April 15 and June 30, 2013.

* A minimum of 3 officers should be submitted with complete contact information. All officers must be current IRA members and maintain membership throughout their leadership term.

* A current council membership list (preferably in an Excel Spreadsheet) needs to be attached. Each council must have 10 IRA members, which should be clearly indicated.

* Sections marked with an asterisk must be completed prior to submission of the form.

STATE AND PROVINCIAL COUNCIL INFORMATION

* Full State/Provincial Council Name (no abbreviations)

* State/Province

* Annual dues

* Total Council Membership

* Total IRA Members

Council Website URL

* Dues collection

Unified (State/provincial and local dues are collected together, thus membership at both levels is automatic).

Separate from local/special interest (State/provincial and local dues are not collected together, thus membership in each is a separate fee and membership in both is not a requirement).

Upload State/Provincial Council Membership List

* Upload State/Provincial Council Membership List (Excel Spreadsheet is recommended. Please indicate 10 IRA members).

2013-2014 State/Provincial Council Leaders

IRA COORDINATOR

First Name

Last Name

IRA number

Preferred Email Address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

IRA COORDINATOR (Only complete this section if you have 2 people serving in this position)

First Name

Last name

IRA number

Preferred Email Address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

IMMEDIATE PAST PRESIDENT

First Name

Last name

IRA number

Preferred Email Address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

PRESIDENT

First name

Last name

IRA number

Preferred Email Address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

PRESIDENT (Only complete this section if you have 2 people serving in this position)

First name

Last name

IRA number

Preferred Email Address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

PRESIDENT - ELECT

First name

Last name

IRA number

Preferred Email address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

VICE PRESIDENT

First name

Last name

IRA number

Preferred Email Address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

SECRETARY

First name

Last name

IRA number

Preferred Email Address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

SECRETARY (Only complete this section if you have 2 people serving in this position)

First name

Last name

IRA number

Preferred Email address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

TREASURER

First name

Last name

IRA number

Preferred Email Address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

DIRECTOR OF MEMBERSHIP DEVELOPMENT

First name

Last name

IRA number

Preferred Email Address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

DIRECTOR OF MEMBERSHIP DEVELOPMENT (Only complete this section, if you have 2 people serving in this position)

First name

Last name

IRA number

Preferred Email address

Confirm Email Address

Preferred Telephone Number

Preferrred Mailing Address

COUNCIL STAFF (Only complete this section if you have an employee who earns a salary or receives monetary payment from the council)

POSITION TITLE:

First name

Last name

IRA number

Preferred Email address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

EXEMPLARY READING PROGRAM CHAIRPERSON

First name

Last name

IRA number

Preferred Email address

Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

Permission to publish email address contact information

State/Provincial Annual Conference (this information will also be published on our website)

2013 State/Provincial Annual Conference Dates

2013 State/Provincial Annual Conference Location

2013 State/Provincial Annual Conference Chairperson

2014 State/Provincial Annual Conference Dates

2014 State/Provincial Annual Conference Location

2014 State/Provincial Annual Conference Chairperson

US State Councils Only - Required Financial/Legal Documentation

* Employer Identification Number (EIN)

Attach IRS 990N (E-postcard) /990EZ /990 Reporting Confirmation for FY ending June 30, 2012

* US State Council Incorporated

Yes

A financial audit is recommended. Please indicate when your council most recently had an external audit by an accountant or other legal advisor.

Individual Completing Form

* First name

* Last name

* Preferred Telephone Number

* Email address (upon successful completion an email will be sent to this address)

* Confirm Email Address

* Indicates Response Required