2017 - 2018 Lions Club Officers
Use this form for District 14-N purposes only
A PU-101 must still be filed with International by signing in here and following the prompts
Any change in club officers during the fiscal year must be reported to International
Club Identification, Club Number and Member Numbers can be found on the semi-annual per capita form

Club Identification  
Club Number  
District 14-N Pennsylvania Club Name                    
Language/Country English/USA
Regular Meeting Place, include address

Club Mailing Address
 

Place                             
Street Address                             
City                             
Regular Meeting Days and Time  
Club's Website 
President's Name                              Member Number                             
President's Street Address  
City                        State                             Zip                             
Home Telephone     Cell Phone      Work Telephone           Fax          
Email Address  Spouse's/Adult Companion's Name
Secretary's Name                              Member Number                             
Secretary's Street Address  
City                        State                              Zip                             
Home Telephone  Cell Phone   Work Telephone           Fax          
Email Address  Spouse's/Adult Companion's Name
Treasurer's Name                              Member Number                             
Treasurer's Street Address  
City                        State                              Zip                             
Home Telephone  Cell Phone  Work Telephone           Fax          
Email Address  Spouse's/Adult Companion's Name 
First Vice President's Name                              Member Number                             
First Vice President's Street Address  
City                         State                             Zip                             
Home Telephone      Cell Phone      Work Telephone           Fax          
Email Address  Spouse's/Adult Companion's Name
Second Vice President's Name                              Member Number                             
Second Vice President's Street Address  
City                       State                             Zip                             
Home Telephone     Cell Phone      Work Telephone           Fax          
Email Address  Spouse's/Adult Companion's Name
Membership Chairperson's Name                              Member Number                             
Membership Chairperson's Street Address  
City                         State                              Zip                             
Home Telephone      Cell Phone  Work Telephone          Fax         
Email Address  Spouse's/Adult Companion's Name

         

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