ASPMN 2018 Chapter Annual Report Survey

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* 3. Chapter Mailing Address

Address

City

State

Zip code

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* 4. Tax ID Number

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* 5. In what state were your Articles of Incorporation filed?

State

Date Filed

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* 6. In 2018, did your chapter file its state Annual Report in the state in which your chapter is incorporated?

Yes

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* 7. Date your chapter was registered (chartered) at the ASPMN National Office.

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* 8. Our chapter has filed IRS Form 1024 and has been approved as a tax exempt organization.

Yes

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* 9. Amount of Chapter Dues charged

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* 10. Chapter total financial assets/bank balance as of January 30, 2018

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* 11. Chapter total financial assets/bank balance as of December 31, 2018

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* 12. An audit of our chapter's financial assets was conducted in 2018.

Yes

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* 13. All Board and Committee meeting minutes are on file with the chapter.

Yes

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* 14. If there were any changes to your chapter's bylaws in 2018, please list the changes here.

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* 15. Our chapter will file its IRS form 990EZ or 990N by May 15 and a copy will be provided to the ASPMN National Office (ASPMN@kellencompany.com) by May 31, 2019.

Yes

Other (please specify)

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* 16. 2018 Chapter Meetings.

Total number of Meetings

Number of Face to Face Meetings

Number of Virtual Meetings (conference call/video call)

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* 17. Chapters are required to hold at least one educational event per year. Please provide the following information about your chapter's educational session(s) in 2018.

Topic

Description

Speaker Names

Length of Program (hours)

Live or Virtual

Number of attendees

Fees charged

Sponsorship Funding Provided By:

# of CEs offered

CE Provider

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* 18. If you held a second educational event, please provide the following information about that event.

Topic

Description

Speaker Names

Length of Program (hours)

Live or Virtual

Number of attendees

Fees charged

Sponsorship Funding Provided By:

# of CEs offered

CE Provider

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* 19. List recognition/awards/scholarships given and name(s) of recipients.

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* 20. List the goals your chapter accomplished in the past year.

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* 21. List any goals in progress from the past year.

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* 22. List any new goals for 2019.

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* 23. Describe any chapter work with legislators or government agencies.

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* 24. Describe any fundraising efforts.

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* 25. Describe any ways that your chapter has supported pain management nursing research.

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* 26. Number of chapter members.

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* 27. Number of new members this year.

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* 28. Chapter membership has:

Increased

Remained the same

Decreased

Other (please specify)

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* 29. If you have a chapter newsletter, how often is it distributed?

weekly

monthly

quarterly

bi-annually

annually

Other (please specify)

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* 30. How are members reminded to renew their chapter membership?

Mail

Phone Call

Other (please specify)

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* 31. Are all chapter members current members of ASPMN?

Yes

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* 32. Describe how your chapter encourages members to be involved with chapter activities.

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* 33. How do you welcome new or transferred members?

Mail

Phone call

Other (please specify)

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* 34. How many members of your chapter also serve at the national level as board members, committee chairs or committee members?

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* 35. Please list your chapter's Board members: names and term expiration

President

Vice President

Secretary

Treasurer

Past President

At Large Member 1

At Large Member 2

At Large Member 3

At Large Member 4

At Large Member 5

At Large Member 6

Other:

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* 36. What is the name of your incoming president (if known)

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* 37. List your Chapter's committees and committee chairs.

Committee 1

Committee 2

Committee 3

Committee 4

Committee 5

Committee 6

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* 1. Chapter

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* 2. Name of Current Chapter President

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* 3. Chapter Mailing Address

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* 4. Tax ID Number

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* 5. In what state were your Articles of Incorporation filed?

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* 6. In 2018, did your chapter file its state Annual Report in the state in which your chapter is incorporated?

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* 7. Date your chapter was registered (chartered) at the ASPMN National Office.

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* 8. Our chapter has filed IRS Form 1024 and has been approved as a tax exempt organization.

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* 9. Amount of Chapter Dues charged

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* 10. Chapter total financial assets/bank balance as of January 30, 2018

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* 11. Chapter total financial assets/bank balance as of December 31, 2018

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* 12. An audit of our chapter's financial assets was conducted in 2018.

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* 13. All Board and Committee meeting minutes are on file with the chapter.

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* 14. If there were any changes to your chapter's bylaws in 2018, please list the changes here.

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* 15. Our chapter will file its IRS form 990EZ or 990N by May 15 and a copy will be provided to the ASPMN National Office (ASPMN@kellencompany.com) by May 31, 2019.

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* 16. 2018 Chapter Meetings.

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* 17. Chapters are required to hold at least one educational event per year. Please provide the following information about your chapter's educational session(s) in 2018.

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* 18. If you held a second educational event, please provide the following information about that event.

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* 19. List recognition/awards/scholarships given and name(s) of recipients.

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* 20. List the goals your chapter accomplished in the past year.

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* 21. List any goals in progress from the past year.

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* 22. List any new goals for 2019.

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* 23. Describe any chapter work with legislators or government agencies.

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* 24. Describe any fundraising efforts.

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* 25. Describe any ways that your chapter has supported pain management nursing research.

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* 26. Number of chapter members.

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* 27. Number of new members this year.

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* 28. Chapter membership has:

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* 29. If you have a chapter newsletter, how often is it distributed?

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* 30. How are members reminded to renew their chapter membership?

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* 31. Are all chapter members current members of ASPMN?

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* 32. Describe how your chapter encourages members to be involved with chapter activities.

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* 33. How do you welcome new or transferred members?

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* 34. How many members of your chapter also serve at the national level as board members, committee chairs or committee members?

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* 35. Please list your chapter's Board members: names and term expiration

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* 36. What is the name of your incoming president (if known)

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* 37. List your Chapter's committees and committee chairs.

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* 38. What is the biggest challenge that your chapter is currently facing?

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* 39. Other comments/feedback/suggestions for ASPMN's Board of Directors or National Office.