Chapter Officer Report (2021-2022 term)

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.

______________________________________________________________________________

International Literacy Association relies on an accurate and complete Officers Report Form to ensure effective communication with your chapter leadership team throughout the year. It is required that the ILA Coordinator complete the Officer Report Form, as he/she is the official liaison with ILA. If the Chapter does not have a Coordinator, it is the responsibility of the President.

Important Requirements for Chapters to Remain Active:

* All 2021-2022 Officer Report Form submissions must be completed electronically by June 30th, 2020 (Midnight, Eastern Standard Time) prior to the new term beginning on July 1, 2021.

*Please note that this online form will no longer be available after June 30, 2021.

* A minimum of 3 officers should be submitted with complete contact information.

* All Officers must be current ILA members and maintain membership throughout their entire leadership term. (July 1, 2021 - June 30, 2022)

* A current chapter membership list (in an Excel Spreadsheet) needs to be attached. In addition to Officers, all Board Members must be ILA members. (full group affiliates only). These members should be clearly indicated on membership list.

* Sections marked with an asterisk are required fields.

* If we do not receive your online submisson by the June 30th deadline, the Chapter will not be eligible to participate in ILA Chapter Awards and may cause your affiliation with ILA to be in jeopardy. Note: If all positions are not finalized by the due date it is best to still submit your form and follow up later with any updates via email to chapters@reading.org.

CHAPTER INFORMATION

Name of Chapter (no abbreviations) *

Preferred Chapter Mailing Address (This address will be used for chapter communications and shipments, and any other required mailing) *

Mailing Address line 2

City *

State *

Zip code *

Chapter Email Address

Annual dues *

Total Chapter Members *

Total ILA Members *

Dues collection

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

Chapter Website URL (this information will also be published on our website)

Social Media Handles -This information will be used to connect to ILA's social media and share information.

+-

Chapter Membership List

Upload current Chapter Membership List (Excel Spreadsheet) Please indicate chapter officers/chapter board members. *

Local Chapters

Please upload a list of your active Local Chapters. The list should include the local chapter name (new, existing, or name change) and contact person's name and email address. Please indicate whether or not the Local Chapters pay annual dues and if so the amount. (Excel spreadsheet) *

IMMEDIATE PAST PRESIDENT (term ending June 30, 2021)

First Name

Last name

ILA number

Preferred Email Address
Confirm Email Address

Preferred Telephone Number

Preferred Mailing Address

2021-2022 Chapter Leaders

Please keep in mind that the Chapter Officers you include below go into effect as of JULY 1.

ILA COORDINATOR (July 1, 2021 - June 30, 2022)

First Name

Last Name

ILA number

Is this a new position for this individual? (Yes or No) If yes, please be sure ILA has received a copy of the approved application.

Preferred Telephone Number

Preferred Email Address
Confirm Email Address

Preferred Mailing Address

PRESIDENT/CHAIR (July 1, 2021 - June 30, 2022)

First name

Last name

ILA number

Preferred Telephone Number

Preferred Email Address
Confirm Email Address

Preferred Mailing Address

PRESIDENT/CHAIR - ELECT (July 1, 2021 - June 30, 2022)

First name

Last name

ILA number

Preferred Telephone Number

Preferred Email address
Confirm Email Address

Preferred Mailing Address

VICE PRESIDENT/CHAIR (July 1, 2021 - June 30, 2022)

First name

Last name

ILA number

Preferred Telephone Number

Preferred Email Address
Confirm Email Address

Preferred Mailing Address

SECRETARY (July 1, 2021 - June 30, 2022)

First name

Last name

ILA number

Preferred Telephone Number

Preferred Email Address
Confirm Email Address

Preferred Mailing Address

TREASURER (July 1, 2021 - June 30, 2022)

First name

Last name

ILA number

Preferred Telephone Number

Preferred Email Address
Confirm Email Address

Preferred Mailing Address

AT LARGE BOARD MEMBERS (July 1, 2021 - June 30, 2022)

Please upload list of AT LARGE BOARD MEMBERS. Excel spreadsheet (include First , Last Name, and ILA Number). *

LEGISLATIVE CHAIR (July 1, 2021- June 30, 2022)

First name

Last name

ILA number

Preferred Telephone Number

Preferred Email address
Confirm Email Address

Preferred Mailing Address

EXEMPLARY READING PROGRAM CHAIRPERSON (July 1, 2021- June 30, 2022)

First name

Last name

ILA number

Preferred Telephone Number

Preferred Email address
Confirm Email Address

Preferred Mailing Address

CHAPTER STAFF (Only complete this section if you have a part time or full time employee who earns a salary or receives monetary payment from the chapter.

POSITION TITLE:

First name

Last name

ILA number

Preferred Email address
Confirm Email Address

POSITION TITLE:

First name

Last name

ILA number

Preferred Email address
Confirm Email Address

POSITION TITLE:

First name

Last name

ILA number

Preferred Email address
Confirm Email Address

Annual Conference (this information will be published on our website)

2021 Conference Dates

2021 Conference Location/Virtual

2022 Conference Dates

2022 Conference Location/Virtual

Chapters - Required Financial/Legal Documentation

Employer Identification Number (EIN) - US Chapters only

Have you filed your recent 990 tax form?

Yes

No

Please attach the most recent IRS tax form that was filed (990N (E-postcard) /990EZ /990)

Please attach a copy of your recent budget/financial statement.

Chapters Activities Report

Please download file listing major programs (planned/completed) *

Contact Person (Individual Completing Form)

First name *

Last name *

ILA Membership Number

Chapter Position: *

Preferred Telephone Number *

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