Lions of Illinois Foundation

CLUB OFFICER REPORTING FORM
return to the Foundation by May 15, 2008

District______________ Club #_______________ Club Name____________________________________

PRESIDENT** The mailing address cannot be a PO Box due to U. S. Postal Services regulations.

Name: ____________________________________________ Spouse:______________________________

Address: ___________________________________________ Res: (_____)_________________________

City: ________________________ State : _____ Zip: ________ Bus:(____)__________________________

E-Mail address: _________________________________________________________________________

Name: ____________________________________________ Spouse:______________________________

Address: ___________________________________________ Res: (_____)_________________________

City: ________________________ State : _____ Zip: ________ Bus:(____)__________________________

E-Mail address: _________________________________________________________________________

TREASURER

Name: ____________________________________________ Spouse:______________________________

Address: ___________________________________________ Res: (_____)_________________________

City: ________________________ State : _____ Zip: ________ Bus:(____)__________________________

E-Mail address: _________________________________________________________________________

CANDY DAY CHAIRPERSON

Name: ____________________________________________ Spouse:______________________________

Address: ___________________________________________ Res: (_____)_________________________

City: ________________________ State : _____ Zip: ________ Bus:(____)__________________________

E-Mail address: _________________________________________________________________________

TOOTSIE POP DAY CHAIRPERSON

Name: ____________________________________________ Spouse:______________________________

Address: ___________________________________________ Res: (_____)_________________________

City: ________________________ State : _____ Zip: ________ Bus:(____)__________________________

E-Mail address: _________________________________________________________________________

SIGHT & SOUND SWEEPSTAKES CHAIRPERSON**

Name: ____________________________________________ Spouse:______________________________

Address: ___________________________________________ Res: (_____)_________________________

City: ________________________ State : _____ Zip: ________ Bus:(____)__________________________

E-Mail address: _________________________________________________________________________

** The mailing address cannot be a PO Box due to U. S. Postal Services regulations.

SOCIAL SERVICES & REFERRALS CHAIRPERSON/FOUNDATION LIASON

Name: ____________________________________________ Spouse:______________________________

Address: ___________________________________________ Res: (_____)_________________________

City: ________________________ State : _____ Zip: ________ Bus:(____)__________________________

E-Mail address: _________________________________________________________________________