New Chapter Application - Chi Sigma Iota

NEW CHAPTER INFORMATION
Requested Chapter Greek Name
Chapters may select a proposed chapter Greek name. Chapters are encouraged to use the initials of their university name (e.g. University of North Carolina at Greensboro used their initials [UNC] to form Upsilon Nu Chi). Be sure to check the Chapters Directory (http://www.csi-net.org/search/custom.asp?id=1037) to ensure the name is available.
Proposed Chapter Greek Name *
First Name of Person Completing This Form *		Last Name of Person Completing This Form *
Email Address of Person Completing This Form *
University Position of Individual Completing the New Chapter Application *
University Name *

INSTITUTION INFORMATION
A campus based residency is one of the defining characteristics of a campus-based CSI chapter. The campus residency involves opportunities for CSI members and faculty to meet individually, in small groups, and for initiations, as well as presentations and ceremonies for educational, social, and professional purposes. CSI functions are expected to be a part of the co-curricular activities of the counselor education program, some of which (like initiations) will be associated with the residency experiences.
Department or Counseling Program Official Name *
University Address *
Campus Type *Indicate how students attend classes - face to face, online or a hybrid format.
If 'Face to Face on Multiple Campuses,' list the campus names where chapter members are enrolled.e.g., Best University - ABCtown Campus Best University - DEFtown Campus Best University - GHItown Campus
Counseling Program Website *Provide the URL for the counseling program.
Counseling Program Faculty Directory/Website *Provide the URL where counseling program faculty directory can be found. CSI must be able to access a current institutional online faculty profile for each CFA.
Region *Visit http://www.csi-net.org/?Chapter_Regions if you are unsure of your region.
Department / Program Chair Name *
Department / Program Chair Email *
Dean Name *
Dean Email *

ACCREDITATION
The CSI Bylaws require CSI chapters to be established within CACREP-accredited counselor education programs. Only students and alumni of the CACREP-accredited program(s) are eligible to be invited and CFA-approved for CSI membership.
Program Accreditation (select all that apply) *	CACREP (Masters Program) CACREP (Doctoral Program) Not Currently CACREP-Accredited Other Accreditation (please list below)
Please List Other Accreditation Body with Accreditation Date (if chosen above)
Official Names of CACREP-Accredited Programs *
Accreditation Date *Provide the most recent date of accreditation (or reaccreditation).
CACREP Program Directory URL *Insert the correct link to the counselor education program's profile within the CACREP Accredited Program Directory (https://www.cacrep.org/directory/).

CHAPTER MEMBERSHIP ELIGIBILITY
Graduates should be board eligible, qualified for state licensure and/or certification, or national certification and/or credentialing. Indicate below if graduates from your program are eligible for credentialing as professional counselors. Note: Only students and alumni of the CACREP-accredited program(s) are eligible to be invited and CFA-approved for CSI membership.
Graduates are Eligible *
Official Name(s) of CACREP Accredited Program(s) From Which Students May Be Invited *e.g., CACREP-accredited Clinical Mental Health Counseling Master’s Program; CACREP-accredited School Counseling Master’s Program; CACREP-accredited Counselor Education and Supervision Doctoral Program; CACREP-accredited Rehabilitation Counseling Master's Program
Degree Programs Available (select all that apply) *	Masters (48 semester or 60 quarter hours) Masters (60 semester or 90 quarter hours) Doctoral Other (explain below)
If 'Other,' please explain
University Definition of Full-Time Enrollment *	6 Credit Hours per Quarter is considered full time at University 9 Credit Hours per Semester is considered full time at University 12 Credit Hours per Semester is considered full time at University
Chapter Initiation Schedule *CSI's expectation is that chapters invite qualified individuals to apply for membership, CFAs approve qualified applicants and assign them an initiation date, and chapters initiate approved new members within the same year. To facilitate this process, CSI chapters must hold at least one initiation each year to maintain active chapter status. CSI will fulfill up to two initiations per chapter each year (e.g., fall initiation and spring initiation, or fall initiation and summer initiation). Indicate the term(s) during which the chapter will host an initiation.

PROPOSED CHAPTER FACULTY ADVISORS (CFAs)
Chapter Faculty Advisors (CFAs) are approved by CSI. CFAs must be active CSI members, hold a doctoral degree in Counselor Education, and meet all membership requirements listed in the CSI Bylaws (https://www.csi-net.org/resource/resmgr/docs-minutes_&_official_docs/bylaws-2007-2010._amended_20.pdf). Additionally, CFAs must be employed in permanent faculty lines (tenure-track or equivalent) to ensure the short- and long-term stability of the chapter and to have the necessary employment standing to oversee the necessary functions of a chapter (including chapter finances).
CFA Name *
CFA Email *
CFA Faculty Title *The CFA Faculty Title should match what is listed within the institutional faculty profile and faculty member's CV.
If 'Other' checked for CFA Faculty Title above, please provide faculty title.e.g., Clinical Faculty, etc.
CFA Membership Status *
CFA CSI Membership ID *(Log into your member profile at www.csi-net.org to see your CSI Membership ID Number.)
URL to Proposed Primary CFA's Faculty Profile *Please paste the URL for the faculty member's institutional web-profile (e.g., showing faculty title, CV, etc. - www.university.edu/facultyprofile/). CSI must be able to access the CFA's online institutional faculty profile.
CFA Vita *Attach CFA vita
Co-CFA or Back-up CFA? *
Co-/Back-up CFA Name *
Co-/Back-up CFA Email *
Co-/Back-up CFA Faculty Title *e.g., Clinical Faculty, etc.
If 'Other' checked for Co-/Back-up CFA Faculty Title above, please provide faculty title.e.g., Clinical Faculty, etc.
Co-/Back-up CFA Membership Status
Co-/Back-up CFA CSI Membership ID *(Log into your member profile at www.csi-net.org to see your CSI Membership ID Number.)
URL to Proposed Co-/Back-up CFA's Faculty Profile *Please paste the URL for the faculty member's institutional web-profile (e.g., showing faculty title, CV, etc. - www.university.edu/facultyprofile/). CSI must be able to access the CFA's online institutional faculty profile. For example: www.bestunversity.edu/counselingfaculty/pat.brow
Co-/Back-up CFA Vita *Attach Back-up CFA vita
Alternate CFAs *Please list the names of other qualified faculty who may be approved as a second, required CFA in the event that the Primary or Co-/Back-Up CFA is unable to serve. As noted above...Chapter Faculty Advisors (CFAs) are approved by CSI. CFAs must be active CSI members, hold a doctoral degree in Counselor Education, and meet all membership requirements listed in the CSI Bylaws (https://www.csi-net.org/resource/resmgr/docs-minutes_&_official_docs/bylaws-2007-2010._amended_20.pdf). Additionally, CFAs must be employed in permanent faculty lines (tenure-track or equivalent) to ensure the short- and long-term stability of the chapter and to have the necessary employment standing to oversee the necessary functions of a chapter (including chapter finances).

ATTACHMENTS & SUPPORTING DOCUMENTATION
Five eligible individuals must apply for membership online after the chapter is approved. They must then be CFA-approved for membership and initiated in the same year the chapter is chartered.
Prospective Member Names *
Administrative Support Letter
Attach a letter of administrative approval printed on institutional letterhead and signed by the administrator. The letter should include stated support for two, full time faculty counselor educators (preferably CACREP graduates) to serve as Chapter Faculty Advisors, support for maintaining CACREP accreditation, and understanding that the chapter may be deactivated if accreditation is not maintained.
Chapter Administrative Support Letter *
Chapter Chartering Agreement
Complete and attach the Chapter Chartering Agreement. Ensure the fields are filled in at the top of the form (i.e., chapter and university) and all signatures are completed electronically.
Chartering Agreement *
Chapter Faculty Advisor (CFA) Agreement
Complete and attach the Chapter Faculty Advisor Agreement. Ensure the fields are filled in at the top of the form (i.e., chapter, university, and CFA name) and all signatures are provided.
Chapter CFA Agreement *
Chapter Bylaws
All chapters will use the Sample Chapter Bylaws provided by CSI (www.csi-net.org/?Chapter_Bylaws). With few exceptions, most CSI chapters should use the Sample Chapter Bylaws provided as the document is intended to describe minimum requirements for chapter governance that will remain relevant for a long period of time. Chapters may develop a Chapter Leadership Manual to describe specific chapter leader roles and responsibilities that are updated over time. Chapters that desire changes may propose an addendum to the chapter bylaws by completing the Chapter Bylaws Rubric (www.csi-net.org/?Bylaws_Rubric). All proposed changes will be reviewed and must be approved by the CSI Chief Executive Officer. CSI will provide to the chapter a final approved version of the chapter bylaws (with addendum if applicable), which will include an approval stamp and date. The chapter then may hold a vote for members to approve the revised chapter bylaws. CSI will post the most current, approved chapter bylaws on a chapter's group home page (https://www.csi-net.org/search/custom.asp?id=1037).
Chapter Bylaws Format *
Written Invitation to CSI Membership
Submit the chapter's Written Invitation to CSI Membership, which should include all of the information found within the Sample Written Invitation to CSI Membership (http://www.csi-net.org/?Membership_Invitatio). The CACREP-accredited program(s) must be specified - only students/alumni from the CACREP-accredited program(s) are eligible to be invited to apply for membership.
Chapter Written Invitation to CSI Membership *
Maintaining Active Status
Confirm that you have reviewed the Checklist for Maintaining Active Chapter Status (www.csi-net.org/?Chapter_Activate), including the requirements that chapters hold at least one initiation per year and CFAs approve and assign initiation dates to new members at least three weeks prior to chapter initiation ceremonies.
Checklist for Maintaining Active Chapter Status Review *	I have reviewed the Checklist for Maintaining Active Chapter Status.
Proposal for Activating Chapters
After you submit payment on the next screen, you will see a link for the required Proposal for Activating Chapters. Please complete and submit the Proposal for Activating Chapters.
Proposal for Activating Chapters Submission *	I understand the Proposal for Activating Chapters must be submitted next.

NEW CHAPTER APPLICATION PAYMENT
To finalize your application, please indicate how you will complete the $175 payment. To pay online by credit card or PayPal after you submit this application, click the "online" link on our website (www.csi-net.org < Chapters < Chapter Resources < Establish a New CSI Chapter [tab] < #3 Submit the $175 fee) or go to https://www.csi-net.org/store/viewproduct.aspx?id=1768482. To pay by university/chapter purchase order or check, request an invoice by selecting that option within the menu below and a $175 invoice will be sent once your chapter application is recorded.
Chapter Payment Preference *To pay online by credit card or PayPal after you submit this application, click the "online" link on our website (www.csi-net.org < Chapters < Chapter Resources < Establish a New CSI Chapter [tab] < #3 Submit the $175 fee) or go to https://www.csi-net.org/store/viewproduct.aspx?id=1768482

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