ACLP Request a New Networking Group

Complete this form to request the formation of a special interest group (SIG) or caucus. Please ensure you have reviewed the ACLP Policy on SIGs before proceeding.

Include the type of networking group you wish to form in the name you enter into box 3 (e.g., XYZ SIG; ABC Caucus, etc.)

1. Chair *This question is required.

	First name
	Last name
	Degrees
	Email

2. Vice Chair *This question is required.

	First name
	Last name
	Degrees
	Email

3. What's the name of your proposed new interest group? *This question is required.

4. Academy resources requested (check all that apply): *This question is required.

Listserv
Webpage
Meeting time at the Annual Meeting
Other support request - provide details Please enter an 'other' value for this selection. * This question is required.

5. Upload a single, 2-page document (Word or PDF only please; 1MB file size limit) with the following:

Page 1: A description of the new group, which must be organized under the following three headings: What is the Purpose of this New Group; Planned Goals/Activities; How Will it Benefit ACLP Members.

Page 2: A list of 30 current ACLP members in support of the application. Provide first and last names, and emails of each supporting member; include yourself at the top of the list. If there are less than 30 supporting ACLP members you must include an explanation why your application cannot achieve thre requisite number of supporters. *This question is required.

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