Chapter Check Signer Form


This form must be completed and submitted online by August 15th every year. Please complete a Check Signer Form for each financial institution at which your chapter has accounts. If the authorized check signers change, during the year, the chapter is required to complete a new Check Signer Form. The officers' names submitted on the Check Signer Forms are then bonded by AACN, so it is important that the correct information is on file at the National Office. Any questions should be directed to the Chapters Department. Thank you.


Date: *
(mm/dd/yyyy)
Chapter Name: *
Chapter Financial Code: *
(Four digit number that begins with 4 _ _ _)

Bank Information

Bank Name: *
Address: *
City: *
State: *
Zip Code: *
Phone Number : *
(999-999-9999)

Account Numbers: *

The following members of the above named chapter are co-signing all chapter checks for the current fiscal year. Two signatures are required on all checks.


 Authorized Check Signers

President Name: *
President AACN Member #: *
Treasurer Name: *
Treasurer AACN Member #: *

Other Check Signers (Optional) - (Limited to President-elect & Treasurer-elect)

Additional Name 1:
Title 1:
AACN Member # 1:
Additional Name 2:
Title 2:
AACN Member # 2:

Submitted By: *
Email Address: *

 

 

 

 

revised 2/13

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