Student Chapter Application

Academic Year
Fall
Spring
Spring
Institution Name*
Academic Departments, Colleges, and/or Schools at your institution concerned with any aspect of design, construction, engineering, planning:*
Faculty Advisor
NOTE: Faculty Advisor MUST be a DBIA member in good standing
Faculty Advisor - Name*
First Last
Title
Department
Address*
Street Address Address Line 2 City State ZIP Code
Office Telephone
Email*
Department Website (If available)
Date Faculty Member Joined DBIA*
Student Chapter President
Name
First Last
Academic Major
Expected Graduation Date
Email
Student Chapter Vice President
Name
First Last
Academic Major
Expected Graduation Date
Email
Student Chapter Secretary
Name
First Last
Academic Major
Expected Graduation Date
Email
Student Chapter Treasurer
Name
First Last
Academic Major
Expected Graduation Date
Email
To be individually signed by Faculty Advisor and Chapter Officers
Faculty Advisor*
Date*
MM slash DD slash YYYY
Chapter President*
Date*
MM slash DD slash YYYY
Chapter Vice President*
Date*
MM slash DD slash YYYY
Chapter Secretary*
Date*
MM slash DD slash YYYY
Chapter Treasurer*
Date*
MM slash DD slash YYYY
Required Attachments
- An electronic copy of Student Chapter Roster (in Excel) with full contact information for minimum of six students; information required is name, email and estimated graduation date. Note that this roster must be sent in bi-annually to National by October 30 and February 28
- Proposed Student Chapter Academic Year Budget
- Original copy of signed Student Chapter Constitution (countersigned copy will be returned to Chapter)

Student Chapter Application

Student Chapter Application

Faculty Advisor

Student Chapter President

Student Chapter Vice President

Student Chapter Secretary

Student Chapter Treasurer

To be individually signed by Faculty Advisor and Chapter Officers

Required Attachments