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Petition for Certification as a Chapter of Integrity Form

We, the undersigned, are dues-paid members in good standing of Integrity. Integrity was granted chapter-in-formation status on . We have at least 10 members. We have met at least once in the past two months. We have adopted chapter bylaws in accordance with the national bylaws of Integrity and elected officers. We submitted a Annual Chapter Report this year.

We respectfully submit the attached chapter bylaws and formally request certification as a chapter of Integrity.

The date of this petition is:

Signatures of Officers	Names	Addresses
`______________________________`Convener
`______________________________`Treasurer
`______________________________`Secretary

Complete this form, print it, and mail it to your regional vice president, the national secretary, and the Rochester address below. Don't forget to attach your chapter bylaws!

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No good thing will God withhold from those who walk with Integrity. Psalm 84:11