2023 Professional Chapter Mandatory Annual Report

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Submitter Name

Submitter Email

Chapter Name

Address Line 1

Address Line 2

City/Town

State/Province

ZIP/Postal Code

Country

Does your chapter have a bank account?

Did you receive a payment for over $5000 from anyone or organization?

Yes

If yes, DONATION INFORMATION

Name/Organization

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Date Donated

Reason for payment

Please upload an image of the donation check.

One file only.
512 MB limit.
Allowed types: gif jpg jpeg png.

Total # of Members

Total # of Indigenous Members in Chapter

Chapter Officers and Members

Chapter Officers

You may add or remove officers using the (+)(-) buttons.

Type	Name	Term	Phone	Email	Employer	Title
Type Type Enter other…	Name	Term	Phone	Email	Employer	Title
Type Type Enter other…	Name	Term	Phone	Email	Employer	Title
Type Type Enter other…	Name	Term	Phone	Email	Employer	Title
Type Type Enter other…	Name	Term	Phone	Email	Employer	Title

Chapter Members

You may add or remove members using the (+)(-) buttons.

Name	Email	Employer	Title	Tribe (If applicable)	Current National AISES Member?
Name	Email	Employer	Title	Tribe (If applicable)	Current National AISES Member?
Name	Email	Employer	Title	Tribe (If applicable)	Current National AISES Member?
Name	Email	Employer	Title	Tribe (If applicable)	Current National AISES Member?
Name	Email	Employer	Title	Tribe (If applicable)	Current National AISES Member?

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Chapter Activities

Chapter Activities (Jan – December)

Briefly highlight chapter activities and describe how they connect to the AISES mission. This includes activities such as community service, professional development, seminars/workshops held, invited speakers, mentoring/tutoring programs, fundraising activities, and special honors your chapter held this Year.

Please describe your chapter’s most significant accomplishment over the past year (200 words max and images)

Please describe any new initiatives your chapter started this year (100 words max)

Meeting Minutes

One file only.
512 MB limit.
Allowed types: jpg jpeg pdf doc docx ppt pptx xls xlsx.

Please upload meeting minutes from the reporting period.

Special Recognition

Highlight chapter and individual member’s special honors, awards, etc. (If applicable)

Please check any programs that the chapter members may be interested in participating in

Mentoring college students

Judging science fairs or research presentations (in-person or online)

Helping out with the Regional Conference

Professional Chapter Signed Affiliation Agreement

Please attach your completed Affiliation Agreement

Please attach your completed Affiliation Agreement
One file only.
512 MB limit.
Allowed types: gif jpg jpeg png bmp eps tif pict psd txt rtf html odf pdf doc docx ppt pptx xls xlsx xml avi mov mp3 ogg wav bz2 dmg gz jar rar sit svg tar zip.

Financial Report

A. Beginning of the Year Cash Balance

B. Funds Received

You may add or remove funds using the (+)(-) buttons.

Description	Fund Amount	Operations
Description	Fund Amount
Description	Fund Amount
Description	Fund Amount

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B. Total Funds Received (add from lines above)

C. Expenditures

You may add or remove funds using the (+)(-) buttons.

Description	Expenditure Amount	Operations
Description	Expenditure Amount
Description	Expenditure Amount
Description	Expenditure Amount

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C. Total Expenditures (add from lines above)

D. Ending of Year Cash Balance (Line A + Line B Total - Line C Total)

Bank Statement

Upload your bank statements for the entirety of 2023. You may redact all but the last 4 numbers of the account number.
Unlimited number of files can be uploaded to this field.
512 MB limit.
Allowed types: pdf jpg jpeg .

2023 Professional Chapter Mandatory Annual Report

Chapter Officers and Members

Chapter Activities

Financial Report

Financial Report

American Indian Science and Engineering Society

Contact Info