Constituent Society Health Survey

Name(Required)

First Last

Position(Required)

Email(Required)

Constituent Society(Required)

Finance

Date of Fiscal Year End(Required)

Date of Last Federal Tax Filing(Required)

Total Checking Account Balances from August Statements(Required)

Total Savings Account Balances from August Statements(Required)

Put $0 if you don't have this type of account.

Total Certificate of Deposit (CD) Account Balances from August Statements(Required)

Put $0 if you don't have this type of account.

Total Investment Account Balances from August Statements(Required)

Put $0 if you don't have this type of account.

Did your board formally adopt a budget for the previous fiscal year?(Required)

YES

Upload Budget for the Immediate Past Fiscal Year

List the name of your Constituent Society at the beginning of the file name, for example: New_Mexico_Budget

Drop files here or

Max. file size: 360 MB.

Date of Last Audit(Required)

If your constituent society has not performed an audit, or you are unaware of an audit, enter 01/01/1900 in the field below.

Name of Auditor or Audit Committe Chair(Required)

List Your Financial Account Signatories (Name and Position)(Required)

Leadership

How many officer/director positions were filled by a person new to that role in the past year?(Required)

How many officer(s) or director(s) have served 2 or more terms in their current role?(Required)

How many committee chairs were filled by a person new to that role in the past year?(Required)

How many committee chairs have served 2 or more terms in their current role?(Required)

We have an established plan to fill unexpected vacancy in office of President(Required)

Yes

Date of most recent Annual Report or renewal of state corporation documents.(Required)

If your constituent society has not filed an Annual Report or Renewal, enter 01/01/1900 in the field below.

Date of expiration of most recent Annual Report or renewal of state corporation documents.(Required)

If your constituent society has not filed an Annual Report or Renewal, enter 01/01/1900 in the field below.

If you were unable to establish the last date of your most recent Annual Report or renewal of state corporation documents, please explain why

Please describe any other legal and/or fiscal required responsibilities of your state that were completed.

Membership and Communication

How do you communicate with members in your Constituent Society?(Required)

Check all that apply

Print Newsletter

eNewsletter

Connect Community

Mail

Newsletter Sample

List the name of your Constituent Society at the beginning of the file name, for example: New_Mexico_Aug2022_Newsletter

Max. file size: 360 MB.

Social Media Handles or Pages for Society

If applicable, please list your social media handles or pages for your constituent society in the appropriate fields below. If you do not have one that is listed, leave it blank.

Facebook

Twitter

Instgram

TikTok

Other

Please share any other information that may be important to share with the Constituent Society Steering Committee.