District 5M-11
Club Activities
Monthly Report

Fill out all of the valid fields on this form.  It will be formatted and e-mailed to the addresses at the bottom upon submission.  Once you have received the formatted e-mail please forward them to the list of required recipients.  You are required to send your reports to the following people.

E-mail to: District Governor, Vice-District Governor, 2nd Vice-District Governor, 5M-11 Cabinet Secretary, and Zone Chairman.

Club Name: Month: Year:

Membership #'s:  Last Month Adds Drops Current Total

List upcoming activities and dates:

List activities completed since last report, include the number of members and hours participating in the activity:
1: #Mbrs: #Hrs:
2: #Mbrs: #Hrs:
3: #Mbrs: #Hrs:
4: #Mbrs: #Hrs:
5: #Mbrs: #Hrs:
6: #Mbrs: #Hrs:
7: #Mbrs: #Hrs:
8: #Mbrs: #Hrs:
9: #Mbrs: #Hrs:
10: #Mbrs: #Hrs:
11: #Mbrs: #Hrs:
12: #Mbrs: #Hrs:
 

List contributions, include amount:

Club Secretary Name                        Club Secretary E-Mail Address

Club President Name                        Club President E-Mail Address

Select Zone Chairman:

 
Return to 5M11 On-Line Forms
Revised: 12/09/09