| District Director's Name |
|
| Club |
|
| District |
|
| Division |
|
| Date |
(mm/dd/yyyy) |
| Total Membership
|
Members Present
|
| Club Meets |
Weekly,
Bi-weekly |
|
AM,
Lunch,
PM |
| Meeting Facility: Room size
,
Privacy
,
Cleanliness
|
| Were the following utilized, displayed or
present? |
|
| Club president
interview yielded the following: |
|
| Club publishes a bulletin |
Yes,
No,
Frequency -
|
| Program development
meeting held |
Yes,
No |
| Does club have a budget? |
Yes,
No |
| Does the club have an
active committee system? |
Yes,
No |
| Does the club plan to earn
a National Service Award? |
Yes,
No |
| Did the officers attend
district club officer's training |
Yes,
No |
| Club has active or planned
programs of service in the following areas: |
Community |
|
Youth |
|
Americanism |
|
Prevention of Child Abuse |
|
- other, please specify |
| Will there be ongoing programs throughout
the year? |
Yes,
No |
| If so, what are they? |
|
| Club president's requests for help and
comments on district and national levels: |
|
| Your comments regarding the status of the
club: |
|
|
Enter the Letters you see in the box
|
