CHAPTER ANNUAL FINANCIAL REPORT

Chapter Name:_______________________________________________________________________

Treasurer: ___________________________________________________________________________

Address:_____________________________________________________________________________

Phone Day: (___)_________________________ Evening: (___)___________________

Fax: (___)_________________________ e-mail: _______________________________

Income
Expenses
Local Membership Dues:
(if applicable) $_______ Postage $_______
Workshop/Seminar Fees $_______ Program Costs $_______
Contributions/Grants $_______ Speaker Fees $_______
Other ___________ $_______ Resource material $_______
________________ $_______ Travel Expenses $_______
________________ $_______ Telephone/Fax $_______

________________
________________
(Attach additional pages as needed)

Total

List below all accounts of the chapter.

INSTITUTION
1._____________________________
2._____________________________
3._____________________________
4._____________________________
5._____________________________

$_______
$_______


$_______

 

TYPE ACCOUNT
________________________
________________________
________________________
________________________
________________________

Other ____________
$_______


Total
$_______

 

ACCOUNT #                        BALANCE
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________


(INCLUDE ADDITIONAL PAGES AS NECESSARY)

IF CHAPTER ASSETS EXCEED $2500, INCLUDE ACCOUNT STATEMENTS FOR ALL ACCOUNTS FOR THE PREVIOUS THREE MONTHS.

Treasurer's signature:__________________________________

HMA MEMBERSHIP IS REQUIRED OF ALL CHAPTER MEMBERS

HMA Chapter Roster

New Chapter Information:

Letter to Prospective Chapters
Guidelines for New Chapters
HMA Chapter Application
HMA National Chapter Bylaws

Chapter Annual Report Forms:
Financial Report Forms
Officer Roster Report Form
Chapter Activity Report
3 Digit Zip Code Prefix Area Designation Instructions

Annual Chapter Reports:
Report Instructions
Financial Report
Officer Roster Report
Chapter Activity Report
Annual Report Extension Form

To Chapter Contacts

 

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