Get Involved – ENGAGE

Georgia – Start an ENGAGE Chapter / Chapter Re-Activation Request Form

Please complete the form below. Fields marked with * are required. Once your application is approved, you’ll receive an email with additional information.

Our Membership Year: August 1-July 31

This field is for validation purposes and should be left unchanged.

Select Your School System(Required)

Select Your Division(Required)

Your Name(Required)

First Last

Your Email Address(Required)

Email Address Confirm Email Address

I am(Required)

School Administrator

Teacher

Student

Other

Do you want to start a new Chapter, reactivate an existing Chapter, or receive information?(Required)

Start a new Chapter

Reactivate an existing Chapter

Other

School Name(Required)

School Phone Number(Required)

Cell Phone Number(Required)

School Address(Required)

Street Address Address Line 2 City State ZIP Code

Are you the only Advisor with this Chapter?(Required)

Will you be acting as the primary Advisor or assisting as a Co-Advisor?(Required)

Other Advisor's Name

Other Advisor's Email