Student Chapter Application Academic YearFallSpringInstitution Name*Academic Departments, Colleges, and/or Schools at your institution concerned with any aspect of design, construction, engineering, planning:* Faculty AdvisorNOTE: Faculty Advisor MUST be a DBIA member in good standingFaculty Advisor - Name* First Last TitleDepartmentAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Office TelephoneEmail* Department Website (If available) Date Faculty Member Joined DBIA*Student Chapter PresidentName First Last Academic MajorExpected Graduation DateEmail Student Chapter Vice PresidentName First Last Academic MajorExpected Graduation DateEmail Student Chapter SecretaryName First Last Academic MajorExpected Graduation DateEmail Student Chapter TreasurerName First Last Academic MajorExpected Graduation DateEmail To be individually signed by Faculty Advisor and Chapter OfficersFaculty Advisor*Date* Date Format: MM slash DD slash YYYY Chapter President*Date* Date Format: MM slash DD slash YYYY Chapter Vice President*Date* Date Format: MM slash DD slash YYYY Chapter Secretary*Date* Date Format: MM slash DD slash YYYY Chapter Treasurer*Date* Date Format: MM slash DD slash YYYY Required Attachments An electronic copy of Student Chapter Roster (in Excel) with full contact information for minimum of six students; information required is name, email and estimated graduation date. Note that this roster must be sent in bi-annually to National by October 30 and February 28 Proposed Student Chapter Academic Year Budget Original copy of signed Student Chapter Constitution (countersigned copy will be returned to Chapter) Questions: Contact DBIA at (202) 682-0110 or DBUniversity@dbia.org