Start an FBLA Chapter - Chapter Re-Activation Request Form

Thank you for your interest in FBLA!

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

FBLA Membership Year: August 1-July 31

Membership Dues:

Select a State-Division *

Select a State-District

Select a State-Division first.

Your Name *

Your Email Address *

I am: *

School Administrator
Teacher
Student
Other:

Do you want to start a new chapter, reactivate an existing chapter, or receive information? *

Start a new chapter
Reactivate an existing chapter
Other:

School Name *

School Phone Number *

Cell Phone Number *

School Address *

Are you the only adviser with this chapter? *

Yes
No

Will you be acting as the primary adviser or as an assisting co-adviser? *

I will be the Primary Adviser
I will be the Assistant Adviser or Co-Adviser

Other Adviser's Name

Other Adviser's Email Address