EmailMeForm
USWT Transfer
A transfer form must be submitted to the state organization by the chapter into which the member is transferring.
This form needs the signature of the Member transferring and the President/Secretary of the chapter to which the member is transferring; be sure to have both present at time of submission. Signatures can be done by your mouse, or your finger on a writable screen.
Responses to the online form will be viewed by the USWT Membership Vice President, USWT President, and your state contact. Fill in as much information as you know. Upon completion of the form, click Submit; you will receive a confirmation screen if your form has been successfully submitted. (rev 2017)
Your Email
*
Submitter Name
*
First
Last
Enter the name of the submitter
Position
*
Phone
###
-
###
-
####
Address
Street Address
City
State / Province / Region
Postal / Zip Code
Date Submitted
*
MM
/
DD
/
YYYY
State
*
Please select
Arizona
Illinois
Iowa
Massachusetts
Minnesota
Missouri
Nebraska
New Jersey
North Dakota
Oklahoma
Pennsylvania
South Dakota
Wisconsin
Cyprus
Other
Other State
*
If you are a member of a state organization not listed, please enter your state.
Transfer Information
Number
Enter the member number if it is known
Name
*
First
Last
Enter the name of the member who is transferring
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Anniversary Date
MM
/
YYYY
Transfer from Chapter Name
*
Enter the name of the chapter from which to disaffiliate
Transfer from Chapter Number
Enter the name of the chapter number from which to disaffiliate
Transfer from State Name
*
Please select
Arizona
Illinois
Iowa
Massachusetts
Minnesota
Missouri
Nebraska
New Jersey
North Dakota
Oklahoma
Pennsylvania
South Dakota
Wisconsin
Cyprus
Other
Enter the name of the state from which to disaffiliate
Transfer from Other State Explanation
*
If you are a member of a state organization not listed, please enter your state.
Transfer to Chapter Name
*
Enter the name of the chapter to which the member wishes to belong
Transfer to Chapter Number
Enter the name of the chapter number to which the member wishes to belong
Transfer to State Name
*
Please select
Arizona
Illinois
Iowa
Massachusetts
Minnesota
Missouri
Nebraska
New Jersey
North Dakota
Oklahoma
Pennsylvania
South Dakota
Wisconsin
Cyprus
Other
Enter the name of the state to which the member wishes to belong
Transfer to Other State Explanation
*
If you are a member of a state organization not listed, please enter your state.
Member's Signature
*
Clear
Enter an electronic signature of the member who wishes to transfer to the new chapter
President/Secretary Signature
*
Clear
Enter an electronic signature of the President/Secretary of the chapter to which the member is transferring
