2010 - 2011 Lions Club Officers

2012 - 2013 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 Name
Secretary's Name	Member Number
Secretary's Street Address
City	State	Zip
Home Telephone Cell Phone	Work Telephone	Fax
Email Address	Spouse'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 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 Name

Please click the submit button only once. It may take a few minutes to transmit the data, depending on your internet connection speed. Copies of the report are automatically sent to the District officials who are to receive a copy.

When the data has been entered, a confirmation screen will appear that shows what was entered. A copy of the record can be printed by clicking "print" at the top of the web browser screen or by right clicking the mouse button and choosing "print."

Some browsers will not accommodate this form. If you have a problem and it persists, please contact the webmaster. Thank you.