* Does your school wish to continue as a chartered member of the ACS ChemClub Program for the 2015-2016 school year?
* Why do you wish to discontinue your ChemClub association?
* Is there another teacher that would be willing to take over the ChemClub?
* Will you like to start a ChemClub at your new school?
* Will you continue as advisor for the ChemClub at your school?
Please provide contact information for the new advisor for the next academic year.
* Do you have any co-advisors?
If more than 1 coadvisor, please list the others in the the comment section at the bottom.
* Indicates Response Required