Student Chapter Organizing Petition: (Name of School)

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Student Chapter Organizing Petition

The undersigned students of _______________________________________________________________ petition


(name of school)

the Board of Directors of the _________________________________________________________ to authorize the


(name of sponsoring ACI Chapter)

formation of a student chapter to be named___________________________________________________________.


(name of student chapter)

The student chapter will function as a section of, and be responsible to, the above captioned ACI professional Chapter.
The following person, who is a faculty member of the above captioned school, a member of the sponsoring ACI
professional Chapter, and a member of ACI, has agreed to serve as advisor to the student chapter:

Advisor’s Name: _________________________________________________________________________

Position/Title: _________________________________________________________________________

ACI Member #: _________________________________________________________________________

Email Address: _________________________________________________________________________

Phone Number: _________________________________________________________________________

Mailing Address: _________________________________________________________________________

_________________________________________________________________________

City/State/Province: _________________________________________________________________________

Country/Postal Code: _________________________________________________________________________

This petition was signed at ____________________________________, this _____ day of ____________, _______
(location) (day) (month) (year)

1. _______________________________________________________ ACI Member # __________________

2. _______________________________________________________ ACI Member # __________________

3. _______________________________________________________ ACI Member # __________________

4. _______________________________________________________ ACI Member # __________________

5. _______________________________________________________ ACI Member # __________________


6. _______________________________________________________ ACI Member # __________________

7. _______________________________________________________ ACI Member # __________________

8. _______________________________________________________ ACI Member # __________________

9. _______________________________________________________ ACI Member # __________________

10. _______________________________________________________ ACI Member # __________________

11. _______________________________________________________ ACI Member # __________________

12. _______________________________________________________ ACI Member # __________________

13. _______________________________________________________ ACI Member # __________________

14. _______________________________________________________ ACI Member # __________________

15. _______________________________________________________ ACI Member # __________________

16. _______________________________________________________ ACI Member # __________________

17. _______________________________________________________ ACI Member # __________________

18. _______________________________________________________ ACI Member # __________________

19. _______________________________________________________ ACI Member # __________________

20. _______________________________________________________ ACI Member # __________________

21. _______________________________________________________ ACI Member # __________________

22. _______________________________________________________ ACI Member # __________________

23. _______________________________________________________ ACI Member # __________________

24. _______________________________________________________ ACI Member # __________________

25. _______________________________________________________ ACI Member # __________________

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