APO LEADS Certificate or Sticker Request Form

This form is for those participants of APO LEADS courses that have not yet received their certificate of completion, or appropriate stickers for their certificate. Normally, certificates are sent out by the National Office Staff within four to six weeks after completion of a given course. Stickers should be available immediately after completion of the course. If it has been longer than this time period and you still have not received your certificate and/or stickers, please use this form to inform the National Office Staff so that they may send you your certificate.

Note 1: Since the National Office Staff are very busy people, please DO NOT use this form if it has not been at least four to six weeks that you have not received your certificate.

Note 2: If the roster for your LAUNCH course was sent to the National Office after May 1, the certificates will not be mailed until the end of August to avoid being lost during the summer lull of campus mail.

Contact Name:


[ First Name ]	[ Last Name ]

Email Address:

National Membership Number:

(six-digit number from your membership card)

Life Membership Number:

(four or five-digit number from your life membership card)

Chapter/PG/IG:

Address (to send certificate):

Street:
City:
State:
Zip Code:
Preferred Phone Number:	(format: xxx-xxx-xxxx)

Please specify which APO LEADS courses you have attended?

LAUNCH

EXPLORE

ACHIEVE

DISCOVER

SERVE

Is there any additional information that we should be aware of in order to process this request more efficiently?