2019 - 2020 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
Club LCIF Coordinator's Name                              Member Number                             
LCIF Coordinator Chairperson's Street Address  
City                         State                          Zip          
Home Telephone      Cell Phone  Work Telephone          Fax         
Email Address  Spouse's/Adult Companion's Name
Club Service Chairperson's Name                         Member Number                             
Service Chairperson's Street Address  
City                         State                          Zip          
Home Telephone      Cell Phone  Work Telephone          Fax         
Email Address  Spouse's/Adult Companion's Name
Club Marketing Communication Chairperson's Name    Member Number                             
Marketing 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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