Zone 11 West

Monthly Membership and Activities Report

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For your convenience if there is a problem with the electronic report.

___________________________________________________________________________________________________________

* or red outline/type indicates required fields

 

*Ident.
*Club No.

*Date

*Club Name
*Secretary's Name
*Secretary's E-Mail Address

*Address


*Total

Entire Table Below Required

Please indicate below the number of
members in each category
Active
Members at Large
Affiliate
Honorary
Life
Privileged


Average Monthly Attendance(in %)
Number of Completed Service Activities
Number of Board Meetings held

Club Meets

(D)Club Use-Please fill out in full

Please enter number of members dropped for each reason listed. One
Reason only for each dropped name.

1. Resigned in Good Standing
2. Dropped for non-payment of dues
3. Dropped for non-attendance
4. Dropped for non-attendance and
                non payment of dues
5. Transferred in Good Standing
6. Moved (dues unpaid)
7. Deceased
8. Other (please specify)
9. TOTAL (must agree with total number of drops)
List all names in the dropped members section

 


Total
Members from Last Report
Transaction Code
A New Members (shown below)
B Reinstated Members
C Transfer Members Accepted
(list name of former club below)
( if dropped over 6 months add as new) 
Total before Deductions
D Dropped from Membership
Members at close of month

 


List Below all new Members, drops and changes of address. Names of Members must be given
in all cases or changes cannot be made. Transaction codes: A=New, B=Reinstated
C=Transfer Ins, E=Changes of Address, F=Change of Name, former name in parentheses

Transaction Code
Added Members Name
Mailing Address
City
Province/State
Postal/ZIP Code
Gender
Year of Birth
Occupation
Sponsors Name
Former Club
E-Mail Address

Transaction Code
Added Members Name
Mailing Address
City
Province/State
Postal/ZIP Code
Gender
Year of Birth
Occupation
Sponsors Name
Former Club
E-Mail Address

 

Transaction Code
Added Members Name
Mailing Address
City
Province/State
Postal/ZIP Code
Gender
Year of Birth
Occupation
Sponsors Name
Former Club
E-Mail Address




Enter Dropped Members Below. The codes for reasons for drops are listed above (see D)
Member #
Name
Reason Code



Report Service Activites when completed, Fund Raising Activites only if outstanding.

*Club Presidents Name:


 

 

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