• LOCAL CHAPTER AFFILIATION FORM

    LOCAL CHAPTER AFFILIATION FORM

  • Welcome!

    To complete the application, you'll need the following:

    1. Chapter Chair contact information
    2. Basic chapter data, such as number of members
    3. Member roster saved in an Excel spreadsheet
    4. Chapter's Rules & Regulations or Bylaws (if applicable)

    Review the Guidelines for NKF-CRN Chapter Affiliation if this your first time affiliating or you need a refresher.

    A red asterisk (*) indicates a required field. You will not be able to submit this application if a required field is blank.

    To submit the form, click the "Submit" button at the bottom of the page. This only needs to be done once before leaving the site, not after filling in each section.

    If you close your browser before clicking the "Submit and close" button, your answers will be lost. You will have to re-enter them on your next visit.

    All Local Chapters must abide by the National Council on Renal Nutrition Rules and Regulations. 

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  • Current Membership Totals:



  • Other Officers

  • Required: Chapter's Membership Roster

    Upload a copy of your Local Chapter Membership Roster, as a Microsoft Excel document. Click here to download a template.

    Please name your document in the following format: "[ChapterName]Roster.xls".

    *Roster should include the following:

    • First and last names
    • appropriate credentials (RD, PhD, etc.)
    • preferred mailing address
    • e-mail address
    • If known, please indicate if the local member is also an NKF-CRN national member (not required).

    Click the "Browse" button to find the appropriate file on your computer. Clicking "Save and Continue" will upload the file. The file names CANNOT exceed 50 characters. You may upload over a previous document. Please do not change the filename.

  • Attestation for Operation as an Affiliated Local Chapter

  • By adding your initials to each statement below, the Chapter is affirming it has read and accepted NKF's policies. Read the policies here.

     

  • Statement of Support:

    I agree to support the NKF Council on Renal Nutrition, to accept their Rules and Regulations, and to abide by their guidelines for affiliation.

  • Thank you very much for your time, effort, and support!

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