Name Month Club Name

Please select your divison, your report cannot be sent until you do.

Division 1 Division 2 Division 3 Division 4 Division 5 Division 6 Division 7 Division 8 Division 9

Number of Paid Members Number of officers

email address to send a copy of this form

This report is due on the 10th of each month, except the summer report which is due Sept. 15th

Service Projects:

#.........description of project.... # people involved...# of hrs per person.... total hours.. money spent

1

2

3

4

#.............description....................# people involved...# of hrs per person.....total hours.....$ raised.....$spent

1

2

3

4

Does your club participate in the following projects and if so how much money have you raised?

Interclubs: (an interclub is an activity that your club has such as a social, get together with another club, or a membership drive:)

Interclub #1: Number of members attending

Interclub #2: Number of members attending

Interclub #3: Number of members attending

List the number of members attending the following:

International convention PLS District Convention

Youth Conference Divisional Rally Other

Number of articles sent to a news source These articles were sent to

Number of minutes sent in with report Please add other articles to seperate sheet.

Club Meetings:

Meeting.Date ............# members present............... # advisors present..... Check if program

1

2

3

4

5

Board Meetings:

Meeting Date ..# members present.. # advisors present

1

2

3

4

5

Total number of members attending Kiwanis, Circle K, or Builder's Club meetings this month

Is your club doing well? If not, why not?

Has your club been contacted by your Lt. Governor this month? How were you contacted?

Was contact sufficient? If not, why not?

Would you like contact from: (Check those that apply) Lt. Gov.; Governor ; District Administrator ; District Secretary

Minutes: Please be sure to tell which meeting(s) these are minutes for.

If you would rather attach the minutes in a file, please do it here: attachment 1

and add attachment 2 here