ECV Grand Council - TRASH Database Contact Update Form

Grand Council Database Contact Update Form
This is used to send information on behalf of Grand Council & TRASH
Indicates Required Field*

Chapter *

Year(s) served as Humbug *

Chapter Humbug/Dead Salmon No. (if known)

Updated Contact Information:
First Name: * Nickname (if any): Last Name: *

Address: * City, State: * Zip Code: *

Home Phone: * Cell Phone: E-mail Address: *

Person Completing this Submission (Digital Signature Required):

First Name * Last Name *

* By checking this box I certifiy I am a currently recognized member of Grand Council
(Humbug or XNGH) submitting this request for review.
(All requests will be reviewed and verified before updates are made to the database)

You must certify above to continue.

(Only click submit once! It may take a few seconds to process)