Pod - Annual Report

CASI POD 2018 Annual Report

Deadline: Please complete this web form in it's entirety. This report is due to be completed no later than August 10, 2018.

* Indicates required field

Pod Name *

Person Completing Report: *

First

Last

Person Completing Email *

Person Completing Phone Number *

2018 GPM Voting Delegate *

First

Last

Delegate Membership Expire Date *

Delegate Phone Number *

Delegate Email Address *

Purpose: The purpose of this report is to ensure that each pod has met the CASI obligations outlined in the CASI Bylaws, Article XIII. Article XIII, 13.1.h requires that each Pod submits evidence on an annual basis as part of the Great Peppers Meeting credential process. This evidence must be presented before the stated deadline.

Article XIII - CASI AFFILIATED PODS

13.1.a - Work for benefit/promotion of CASI *

13.1.b Maintain minimum of 25 members *

Yes, we have 25 members No, we do not have 25 members

13.1.c Hold an annual election of officers *

Yes, the Pod held an election No, the Pod did not hold an election

Date of Election: *

13.1.d Hold a Pod CASI cookoff *

Yes, the Pod held a CASI cookoff No, the Pod did not hold a cookoff

Date of Pod Cookoff *

INCOMING - Pod Officers Report

A. GREAT PEPPER: Name *

First

Last

GREAT PEPPER: Address *

Line 1

Line 2

City

State

Zip Code

Country

GREAT PEPPER : CASI Member Expire Date *

GREAT PEPPER: Email *

GREAT PEPPER - Phone # *

B. PEPPER POPPER: Name *

First

Last

PEPPER POPPER - Address *

Line 1

Line 2

City

State

Zip Code

Country

PEPPER POPPER-Member Expiration Date *

PEPPER POPPER - Email *

PEPPER POPPER - Phone Number *

C. SECRETARY: Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

SECRETARY-Member Expiration Date *

SECRETARY - Email *

SECRETARY - Phone Number *

D. TREASURER: Name *

First

Last

TREASURER - Address *

Line 1

Line 2

City

State

Zip Code

Country

TREASURER-Member Expiration Date *

TREASURER - Email *

TREASURER - Phone Number *

II. Regional Referee and Area Referee Nominations for Region

Region Designation (3 letters) *

Pods in Region *

REGIONAL REFEREE Nominee: Name *

First

Last

REGIONAL REFEREE Nominee: Email *

REGIONAL REFEREE Nominee Address *

Line 1

Line 2

City

State

Zip Code

Country

REGIONAL REFEREE Nominee Phone # *

REGIONAL REFEREE Nominee - Member Expiration Date: *

Pod Area Ref 1: Name *

First

Last

Pod Area Ref 2: Name *

First

Last

Pod Area 3 Ref: Name *

First

Last

Pod Area Ref 4: Name *

First

Last

AR Membership 1 Expire Date *

AR Membership 2 Expire Date *

AR Membership 3 Expire Date *

AR Membership 4 Expire Date *

AR Email 1 *

AR Email 2 *

AR Email 3 *

AR Email 4 *

My electronic signature (typed in name) on this form certifies that this Pod has met the required obligations outlined in the CASI Bylaws, Article 13.

Electronic Signature: *

Note: If you need assistance completing this report, please email Keith Karaff, CASIed@casichili.net with questions.

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