EmailMe Form - BNI Rochester - Member Status Report

Today's Date *

MM / DD / YYYY

Chapter Name *

Report Submitted By *

Your Name *

First Last

Your Email Address *

There are three ways a member is to be removed from the chapter membership roster.

1. The member resigns their membership or chooses not to renew.
2. The Membership Committee terminates the membership.*
3. The Membership Committee declines the member's renewal.*

*Requires Director Approval

Member's Name *

First Last

1. Member RESIGNED for the following reason:

This allows the Regional Office to track the reason members have left the organization.

2. Membership Committee TERMINATED the membership for the following reason:

*DIRECTOR APPROVAL REQUIRED prior to submitting this report and notifying the member. The appropriate BNI Accountability Letter must also be sent to the member upon obtaining Director approval.

3. Membership Committee DENIED RENEWAL for the following reason(s):

Lack of Participation

Lack of Referral Given

Lack of Visitors Invited

Other (provided addtional details below)

* DIRECTOR APPROVAL REQUIRED prior to submitting this report and notifying the member. The appropriate BNI Accountability Letter must also be sent to the member.

Additional Information:

Effective Date of Member's Drop: *

MM / DD / YYYY

Enter the date the member notified the chapter of their resignation OR date in which the chapter terminated* the membership.