Affiliate MOU

Instructions

We are now filing all Memo of Understanding forms electronically in our system. Please read the MOU information and complete the electronic Memo Of Understanding form. Included in the electronic MOU form is a section for you to drop in your membership list (in excel format). Please print a copy of the MOU (in pdf form) at the bottom of the page for your records. If you have any questions please feel free to contact us at info@anpd.org or 312-321-5135.

Memo of Understanding Form

Affiliate Name

Affiliate Contact Name & Title

Contact Email Address

Mailing Address

City, State, Zip

Current President

President-Elect

When does your President-Elect take office? *

Current List of Affiliate Membership *

Please read the terms and conditions outlined in the MOU document above and provide your Electronic Signature.

I agree to the terms and conditions outlined in the MOU, this serves as my electronic signature *

What other information would you like included in your affiliate listing?

Submit