Update Your Where We Serve Page

This page is ONLY used to update the information on the Where We Serve page for your state. It is not used to request information, signup for any of our mailing list or become a new volunteer.

Fill out this form to update information on this Where We Serve page ONLY.
Fields marked with an * are required. Complete ONLY the fields that you desire to update. Leave blank all fields not to be changed.

Check if amending information already on the Where We Serve:

             * Your Name:
* Your E-mail Address:

* State/Country:

State Chapter/Country Chair:
                          e-mail:

State Chapter/Country Vice Chair:
                          e-mail:

State/Country Secretary:
                          e-mail:

State/Country Treasurer:
                          e-mail:

State/Country Financial Secretary:
                          e-mail:

International Council Representative:
                          e-mail:

Unit/Location, City, Chair's Name, e-mail:

State Agape Chair/e-mail:

State/Country/Advisory Council Website:

State/Country/Advisory Council Website Admin (please include e-mail address & phone):

facebook Page Address:


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Anti-SPAM Code (not case sensitive):