Go To The Affiliation Form.
Member roster should be completed after submission of the Affiliation Form.
P.O. Box 13294
Ruston, LA 71270
Kayla McGuire-State Director
ELECTRONIC AFFILIATION (PRINT THESE INSTRUCTIONS)
* Do not use apostrophes or commas when submitting the Affiliation Form or Member Roster.
* For the 2012-2013 school year, state and national affiliation for Louisiana FCCLA chapter will be submitted to the state association office for processing. The State Director will then forward to national headquarters the necessary information and payment for the national portion of the dues.
* Each Family and Consumer Sciences teacher that has previously affiliated, has been assigned a
unique chapter ID number for the FCCLA chapter affiliated by that teacher. This Chapter ID number is the same as the one assigned by the national FCCLA office. This information should be used consistently for all chapter affiliations submitted throughout the year.
* To affiliate electronically you will need a printer connected to your computer for printing the hard copy required for your records and for submitting with payment.
* One copy of both the affiliation report and member roster must be mailed with payment to the state director. Checks should be made payable to Louisiana FCCLA. A copy of the affiliation report and member roster must be emailed to the State Director firstname.lastname@example.org.
* Keep a hard copy of your affiliation report and member roster for your records.
* Affiliation must be postmarked by November 1 in order for a chapter to be eligible to run a regional or state officer candidate or compete in regional STAR Events.
* Second semester students affiliation must be postmarked by January 23 in order for students to compete in Star Events that are state level only.
1. CHAPTER DATE- Complete the chapter name, school name, region, address, city, zip code, telephone number, and fax number (include area code) and parish in the appropriate boxes. Chapters will need to indicate their Chapter ID number on the form, followed by school information, and adviser name. If there has been a teacher change it should be reflected on the Affiliation Form, new advisers should use the Chapter ID that was assigned to the teacher that was replaced. If you do not have a Chapter ID number, please contact the state office at (318) 680-1973 for a new Chapter ID.
2. CO-CURRICULAR – Mark the appropriate box to indicate whether your chapter is co-curricular ( a program that integrates Family, Career and Community Leaders of America chapter activities into the Family and Consumer Sciences Education classroom program of study).
3. SCHOOL LOCATION – Select from the drop-down list. Which population best describes the location of your school? Urban (Over 100,000), Suburban (15,000 – 100,000), Small Town (15,000 to 75,000), or Rural (Under 15,000).
4. SCHOOL TYPE – Select the category that best describes your school from the drop-down list.
5. CHAPTER MEMBERSHIP – Complete the number of males, females, and total members in each category included in this payment and shown on the member roster. Also give the total number of members affiliated for the year-to-date. Do not include the adviser in the counts.
6. RACE/NATIONAL ORIGIN – Please enter the total number of members in each category included in this payment. This demographic information will be used determine if the organization is meeting the program and service needs of all members.
7. CHAPTER ADVISER – Complete all adviser information including home address and phone numbers.
8. CONTACT TIME – Please let us know what time of the school day is best to contact you from the drop-down list.
9. YEARS AS ADVISER – Provide the total number of years you have been a chapter adviser. This information will be used to determine the years of service awards.
10. ADVISER EMAIL ADDRESS – EXTREMELY IMPORTANT! Please provide so that necessary confirmation can be emailed.
11. ADDITIONAL ADVISERS – List additional adviser’s names and contact information in the space provided. Include their email addresses as well.
12. DUES- FOR THE 2012-2013 SCHOOL YEAR, THE MINIMUM AMOUNT FOR AFFILIATING A CHAPTER IS $192. This covers the state and national dues payment of one to twelve members. Both state and national dues must be paid for each member and there are no substitutions of names. Indicate how many times you have affiliated for this chapter this year from the drop-down list. Indicate the total number of members for this submission, amount of dues ($192 for the first twelve students plus $16 for each additional student over nine), adviser contribution and the total due. Please DO NOT ENTER SPACES OR SYMBOLS, enter ONLY numbers (i.e., 210 for 210 students, etc.). If you enter extra spaces or characters for any of these three spaces, you will get an error message to that effect when you attempt to SUBMIT. Please indicate the method of payment from the drop-down list. The check number, if available, and the amount of the payment. You need enter this only once. The extra line is provided if needed.
13. MEMBER ROSTER – Enter member names on the member roster in alphabetical order by last name. Also indicate each member’s gender and grade number (i.e., Senior = 12, Junior = 11). Indicate whether the student’s membership is on the basis of present/previous enrollment in a comprehensive/technical course (C) or occupational course (O). If a student is or has been enrolled in both types of courses, count only once in the category with any anticipated STAR Event entry. Do not use apostrophes or commas when submitting the Affiliation Form or Member Roster.
14. SUBMISSION – Print 3 copies (1 for adviser, 1 for school bookkeeper, 1 for FCCLA State Director) of the resulting form BEFORE clicking “Submit”. Keep one set of forms (affiliation form and member roster) and forward the other one set with a payment check payable to Louisiana FCCLA and mail to: Louisiana FCCLA, P.O. Box 13294, Ruston, LA 71273. Email one copy to State Director at: email@example.com.
Early dues payment help ensure that your members receive a full year of services from the state and national associations.
Chapter Affiliation forms should be completed after submission of the Affiliation Form.
Louisiana Association / National Association
FAMILY, CAREER AND COMMUNITY LEADERS OF AMERICA, INC.
Member Affiliation Form