MONTHLY MEMBERSHIP AND ACTIVITIES REPORT - DISTRICT

EMAIL BY  LAST DAY OF MONTH

Send copies to: 1. District Governor. 2. Vice District Governor 3. Your Region Chairman. 4. Your Zone Chairman. 5. Your Club Secretary.

How to Use:    1.  Go to File -Send Page by email.     2. Fill in form.       3. Send to appropriate email addresses

 

Club Name

 

 

Date:     Month/Year

 

 

Secretaries Name

 

 

Home Phone

 

 

Address

 

 

Address (cont )

 

 

City

 

 

State

Pennsylvania

 

Zip Code

 

 

E-Mail:

 

 

 

 

 

 

 

 

 

 

 

Please indicate the numbers in each category

 

 

 

Please enter number of members dropped for each reason.

 

 

 

 

 

Active

 

 

1

Resigned In Good Standing

 

 

 

Members from last report

 

Members at large

 

 

2

Dropped for non-payment of dues

 

 

A

New Members (Shown below)

 

Honorary

 

 

3

Dropped for non-attendance

 

 

B

Reinstated Members

 

Life

 

 

4

Dropped for non-attendance and non-payment of dues

 

 

C

Transfer Members Accepted. Please indicate name of former Club below

 

Privileged

 

 

5

Transferred in good standing

 

 

 

Affiliate

 

 

6

Moved(Dues unpaid)

 

 

 

Average Monthly Attendance % Active Members Only

 

 

7

Deceased

 

 

D

Total Before deductions

 

Number Of Completed Service Activities

 

 

8

Other (Please specify)

 

 

 

Dropped from Membership

 

Number Of Board Meetings Held

 

 

 

 

 

 

 

 

 

Club Meets

A = Weekly, B = Bi-Monthly

C = Monthly

 

 

9

Total Drops

(List Names Below)

 

 

Members at close of month. Includes all membership categories

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NEW MEMBERS

 

 

 

 

 

 

 

 

 

List all new members and their sponsors below

Please indicate Category:

A=New, B=Reinstated, C=Transfer In

 

 

Name of New Member

Sponsor

Category

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dropped Members

 

 

 

 

 

 

 

 

 

List dropped members and reason for drop

(See Codes above :1 thru 8)

 

 

 

 

 

 

Name

Reason

 

Name

Reason

 

Name

Reason

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Activities  (When you get to end of a line please hit return)

1.