District 24-C Lions of Virginia

Club Officer Reporting Form

Note: This form will be submitted to District 24-C.
The PU-101 form to submit to International can be downloaded as a PDF file from here

Club Name: Reporting Year:
E-MAIL ADDRESS (if you want a copy emailed to you):
President: member no
Address 1
Address 2
email address Spouse name
Telephone:
home
work
fax
 
Secretary: member no
Address 1
Address 2
email address Spouse name
Telephone:
home
work
fax
 
Treasurer: member no
Address 1
Address 2
email address Spouse name
Telephone:
home
work
fax
 
Membership Chairperson: member no
Address 1
Address 2
email address Spouse name
Telephone:
home
work
fax