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Please print all information except for signatures (instructions on next page)

Club Name:

Club Address:

Date:

IOBG District #:

Contact Person:

IOBGA Office Held:

Address:

Telephone #:

Fax #:

E-Mail Address:

IOBG District Director:

[print name]

[signature]

IOBG District President: OR

[print name]

[signature]

IOBG Chapter President:

[print name]

[signature]

# of IOBGA members:

Amount of check enclosed: $

(only required for new district)

*FOR INTERNATIONAL USE ONLY*
IOBGA International President:		[signature]
IOBG Area Vice President:		[signature]
IOBG International President:		[signature]
FINAL DISTRIBUTION:	1 copy - IOBGA International President		1 copy - IOBG Executive Secretary

1. Please legibly print all of the information except where signatures are required.

2. The contact person should be the person completing this application, and should hold either a district IOBGA officer’s position or an International officer’s position. We require the address, telephone #, fax # (if applicable) and e-mail address (if applicable) of the contact person.

3. If you are making application for a new district charter, then the signatures of the IOBG District Director and the IOBG District President are required.

4. If you are making application for a new chapter charter, that is, you are already in an organized district, then you require the IOBG District Director’s signature and either the IOBG District President or your IOBG Chapter President’s signature.

5. Once completed, the application is to be forwarded to the IOBGA International President, who will present it to the Executive Board for consideration at their next meeting. The IOBGA International President is responsible for either forwarding the IOBGA approved application to the IOBG for approval, or for issuing a valid reason to the contact person, if the application is denied.

6. When an application is approved, a charter will be forwarded to the contact person. The contact person is responsible for obtaining the signatures of the IOBGA members on the charter, and for returning one copy of the signed charter to the IOBG International Executive Secretary and one copy to the IOBGA International President.

Last modified: September 30, 2008