LIONS

DISTRICT 5M4

MONTHLY CLUB ACTIVITIES REPORT

CLUB NAMEMONTH YEAR

List below the details of your clubs’ activities, donations and volunteer service hours in the following categories.  Completing this report regularly will assist you in completing the annual report to Lions Clubs International by June 30.

SIGHTS SERVICES:        $

                                        HOURS

                            DESCRIPTION:

HEARING SERVICES:     $  

                                          HOURS   

                            DESCRIPTION:

DIABETES SERVICES:    $  

                                          HOURS   

                            DESCRIPTION:

YOUTH SERVICES:         $  

                                        HOURS      

                            DESCRIPTION:

LIONS CLUBS

INTERNATIONAL:            $ 

                                          HOURS     

                            DESCRIPTION:

COMMUNITY

SERVICES:                        $ 

                                      HOURS     

                        DESCRIPTION:

OTHER SERVICE AND

FUND RAISERS:               $ 

                                          HOURS      

                            DESCRIPTION:

NEW MEMBERS:

TRANSFERS:

DROPPED:

TOTAL MEMBERS MONTH END

              DECEASED MEMBER: (if more than one member use a second sheet please)

                    NAME:

                   DATE OF DEATH:

                   MORTUARY CONDUCTING SERVICE

                    MORTUARY ADDRESS:

                   MORTUARY PHONE

 Club Secretary:  Date