IAAI Chapter Liaison Contact Tracking Form
Goals: Maintain a record of information shared with Chapters, track liaison engagement and outreach efforts and provide visibility into Chapter support activities.
Liaison Name
*
First Name
Last Name
Chapter Name & Number
*
Please Select
Alabama 6
Alaska 36
Alberta, Canada 38
Arizona 28
Arkansas 44
Brazil 80
British Columbia, Canada 15
California 22
Central European 81
Chile 82
Colorado 41
Connecticut 49
Delaware 27
Finland 78
Florida 9
France 72
Georgia 8
Gulf Association of Fire Investigators 83
Hawaii 62
Hispano Americo 79
Idaho 56
Illinois 12
Indiana 14
Iowa 30
Ireland 68
Israel 57
Kansas 7
Kentucky 2
Korea 73
Louisiana 42
Maine 60
Maryland 53
Massachusetts 20
Michigan 5
Minnesota 16
Mississippi 40
Missouri 10
Montana 26
Nebraska 13
Nevada 43
New Hampshire 34
New Jersey 17
New Mexico 32
New South Wales, Australia 47
New York 23
New Zealand 45
Nordic Chapter formerly Sweden 61
North Carolina 24
North Dakota 64
Ohio 1
Oklahoma 19
Ontario, Canada 39
Oregon 31
Pennsylvania 29
Quebec 69
Queensland, Australia 59
Rhode Island 51
South Africa 66
South Carolina 33
South Dakota 18
Taiwan 76
Tennessee 4
Texas 3
United Kingdom 67
Utah 50
Vermont 63
Victoria, Australia 58
Virginia 11
Washington 21
West Virginia 46
Wisconsin 25
Wyoming 55
Test 99
Liaison Email Address
*
example@example.com
Date of Contact
*
-
Month
-
Day
Year
Date
Method of Contact
*
Please Select
Phone
Email
In Person
Video Call
Other
Reason for Contact
*
Notes/Follow-up Actions/Summary of Information
*
Any Additional Documentation
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