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2023 Chapter Report Form

Please send completed Chapter Report Forms to ORTA by February 1, 2024.

Print a copy of this form. Complete the form by hand and send it to ORTA. 

You can scan, or take a photo of, your completed form and send it to ORTA via email using this address:


If you are submitting a deceased member report, scroll to the lower portion of this page to complete and submit that form electronically. 

Deceased Member Report 

Please submit passed member(s) from your chapter below. We strive to keep our database as current as possible, so please use this form as needed. 

Thanks for submitting!

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