CLUB NAME CLUB # REPORT MONTH
SECRETARY NAME
PHONE NUMBER
EMAIL ADDRESS
MEMBERS FROM LAST REPORT
NEW MEMBERS (Code A)
REINSTATED MEMBERS (Code B)
TRANSFERRED MEMBERS ACCEPTED (Code C)
TOTAL BEFORE DEDUCTIONS
DROPPED FROM MEMBERSHIIP
TOTAL MEMBERSHIP
PLEASE LIST ALL DROPPED NAMES BELOW WITH CODES THAT APPLY:
1 Resigned in Good Standing
2 Dropped for Non-Payment of Dues
3 Dropped for Non-Attendance
4 Dropped for Non-Attendance & Non Payment of Dues
5 Transferred in Good Standing
6 Moved (Dues Unpaid)
7 Deceased
8 Other (Please Specify)
PLEASE INDICATE BELOW THE NUMBER OF MEMBERS IN EACH CATEGORY:
ACTIVE
MEMBERS AT LARGE
HONORARY
LIFE
AFFILIATE
Average Monthly Attendance
Number Completed Service Activities
Number of Board Meetings Held
CLUB MEETS:
___ Weekly ___ Semi-Monthly ___ Other
MEMBERSHIP INFORMATION
Please List All NEW MEMBERS and their SPONSORS Below (Indicate Category A=NEW B=REINSTATED C+TRANSFERRED IN
CATEGORY
First -MI-Last Name
SPONSOR
CATEGORY
First -MI-Last Name
SPONSOR
CATEGORY
First -MI-Last Name
SPONSOR
DROPPED MEMBERS – LIST DROPPED MEMBERS AND REASON (See Codes Above)
Name
Code
Name
Code
Name
Code
ACTIVITIES – Report Service Activities, Fund-raising, upcoming events, donations, visitations, etc. below