Affinity Group Application

Date

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Submitter Name (AG Coordinator)

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Submitter Email

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Names and email addresses of any other founding members

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Proposed Name of AG

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Mission

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AG Membership Structure

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Roles and Responsibilities (if applicable)

Coordinator

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Co-Coordinator

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Participating Member Names

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Succession Plan

AG Business

Renewal of the AG application will occur every three years. AGs are not required to submit an Annual Report, updated Standard Operating Procedures (SOP), or annual budget request. However, AGs may develop their own operating SOPs as needed. Additionally as part of the 3-year renewal process, an executive summary report must be submitted to the BOD and, at minimum include the following:

Events or activities that fostered networking, community, information sharing, etc.

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Terms and Conditions

I have read and understood the ACVP Affinity Group SOP and agree to the terms and conditions.

Acceptance of Terms and Conditions

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