CLUB SECRETARIES NOTE:
THIS IS THE ONE AND ONLY FORM THAT WILL BE ALLOWED DURING 2007-2008. IF ANOTHER FORM IS USED, IT WILL BE DISQUALIFIED. PLEASE MAKE COPIES OF THIS REPORT FORM AND FILE ONE, FILLED OUT FOR EACH MONTH, AND SEND TO YOUR REGIONAL AWARD CHAIRMAN AT THE END OF EACH MONTH

ACTIVITIES AND MEMBERSHIP REPORT

DATE OF REPORT:

CLUB NAME:

CLUB NUMBER

GROUP: A (30 or less) or B (over 30 members)

A

B

YOU MUST KNOW THE RULES PRINTED IN THE DIRECTORY

Fill in blanks with a number, where there is a choice circle one or the other, where there is yes or no, circle one or put an X in the box

ADMINISTRATIVE

1

"M" Report on time

YES

NO

100 or -200

2

Activities Report by the First

YES

NO

100 or -200

3

International dues on time

YES

NO

100 or -100

4

District dues on time

YES

NO

100 or -100

ACTIVITIES

5

FUND RAISERS

Net Profit

a

b

c

Total Net Profit

2 per $1 net profit

6

MAN HOURS NON FUND RAISING

a

Hrs

b

Hrs

c

Hrs

d

Hrs

Total Hours

20 per man hour

7

FUNDS SPENT COMMUNITY SERVICE

a

$ -

b

$ -

c

$ -

Total

5 per $1 spent

8

District Blood Bank

Total Pints

500 per pint

9

Monetary Donations to Outreach

$ -

Total

5 per $1 donated

10

Eye Donor Cards sent to Eye Bank

Total

10 ea. Card

11

Hearing Aids:

a

Hearing Aids Donated

Total

100 ea.

b

Hearing Aid Batteries Donated

Total

1 ea.

12

Ink Cartridges donated to camp

Total

1 ea.

13

Youth Exchange:

a

Member Housing Student

Total Weeks

500 per week

b

Club Financial Support

Students

600 per student

14

Eye Glasses:

a

Eye Glasses Turned in to Chair

Total

1 per pair

b

Eyeglass Cases Donated

Total

1 per case

c

Money turned in for Shipping Expenses

$ -

Total

1 per $ turned in

15

Stamps Collected

Total

1 ea stamp

VISITATIONS

16

a

Visiting another Club

Total

100 per club

b

Additional Member(s) above Minimum

Member(s)

20 each member

c

All Clubs in Zone

YES

NO

1000

d

All Clubs in Region

YES

NO

2000

17

a

Council of Governors Meeting

Member(s)

1000 each member

b

International Convention - President or Secretary

Pres./Sec.

3000 each

c

International Convention - other member(s)

Member(s)

2000 each

d

MD-35 Convention - President or Secretary

Member(s)

2000 each

e

MD-35 Convention - other members

Member(s)

1000 each

18

Members attending Cabinet Meeting

a

President or Secretary

Pres./Sec.

1000 each

b

Other member(s)

Member(s)

500 each

c

Members attending Orientation

Member(s)

100 each

d

New Club Members attending for the first time

Member(s)

250 each

19

Members attending Zone Meeting

a

President or Secretary

500 each

b

Other members

Member(s)

100 each

20

Members attending USA/Canada Forum

a

President or Secretary

Pres./Sec.

3000 each

b

Vice Presidents

Vice President(s)

2500 each

c

Other Club Members

Member(s)

2000 each

21

Visit Outreach Programs (other than work parties)

a

Eye Bank

Member(s)

1000 per

b

Conklin Center

Member(s)

1000 per

c

Florida Lions Camp

Member(s)

1000 per

d

Southeastern Guide Dogs

Member(s)

1000 per

22

Visit

a

Leader Dogs for the Blind

Member(s)

2000 per

b

International Headquarters - Oak Brook

Member(s)

2000 per

LEADERSHIP - EXTENSION - MEMBERSHIP

23

Member(s) attending District Governor Gil Francis Organization Meeting on May 31, 2008 ***Can only claim this for July 2008 Activity Report

Member(s)

100 per

24

Member(s) attending a Lions Training Session - 1 Hour Minimum

Member(s)

1000 per

25

Member(s) teaching a Lions Training Session - 1 Hour Minimum

Member(s)

2000 per

26

New or Transferred-in member from out of District

Member(s)

500 per

27

Members dropped, other than transferred, moved or deceased. If transferred, Intl Form ME-20 40M must accompany the M Report

Member(s)

(-400) per

28

Club sponsoring a new:

a

Lions Club (Name of Club)

Lions Club

10,000 per

b

LEO Club (Name of Club)

LEO Club

15,000 per

29

Club Hosting

a

Zone Meeting at:

500 per

b

Cabinet Meeting at:

1000 per

c

Council of Governors Meeting at:

1500 per

Total Points for the Month

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