Secretary's Name
Email address
Total Membership (all types of
members)
If membership
has not changed since last month's report, check the box to the right
and skip to the DG Contest if you participate
Average monthly attendance/percent
of active members only
Number of board meetings held this
month
List below the number of
members dropped for each reason. Please use only one reason for
each dropped member.
Resigned in good standing - Code 1
Please list all dropped
member's names and the reason for the drop (see codes above).
Name 1:
Name 2:
Name 3:
List below each new member.
Be sure he/she is in the proper category: A, B or C
New Member (Category A):
New Member (Category A):
New Member (Category A):
New Member (Category A):
Reinstated Member (Category B):
Transferred Member (Category C):
Number of Members
from last report
Total Members Dropped Total New Members
Members at this Month's End
Please report service activities, fundraising
activities and upcoming events in the box below:
District Governor's Contest
If you do not participate in
the DG Contest, complete only the
blue highlighted lines
below.
GMT Coordination (Membership)
1. For each club that appoints
a GMT chairperson 500 points (one time credit this
Lions year) Your points
2. For each new member 1000 points per member Your points
3. For each new female member 500 points extra per member Your points
4. For each new family member (same
household) 300 points extra per member Your points
5. For each new member who attends a
District, Region or Zone meeting 200 points per member Your points
6. For each new member who attains a
"Proud Lion" award 500 points per member Your points
7. For each club with a net plus
three (3) as of June 30, 2012 4,000 points (one time credit) Your points
8. For Sponsoring a new Lions or Branch
Club 2,000 points each event Your points
9. For Sponsoring and chartering a new Leo
Club 2,000 points each event Your points
10. For each club that appoints a Retention
Chairperson 350 points (one time credit this
Lions year) Your points
11. For any club that, as of
June 30, 2012, does not drop a
member (other than for death or transfer) 1,500 points (one time credit) Your points
GLT Coordination (Leadership)
12. For each club that
appoints a GLT chairperson 500 points (one time credit this
Lions year) Your points
13. For any club officer who attends the
District Leadership Training or completes LCI Leadership Training online 500 points per club officer Your points
14. For each club that receives a
Club Excellence Award 500 points (one time credit this
Lions year) Your points
15. For each club secretary who receives a DG's Secretary's Award 500 points (one time credit this
Lions year) Your points
16. For each club that conducts a club
assessment and/or a community assessment under guidelines of the LIONS
CEP program
300 points (each)
Your points
17. For each club that appoints a club
Orientation Chairperson 350 points (one time credit this
Lions year) Your points
18. For each club that orients new members
using the District Orientation Guide 500 points each new member Your points
19. For each club that has a District
Committee Chairperson as the program for a meeting 500 points each event Your points
Public Relations
20. For each club that appoints a Public
Relations Chairperson 350 points (one time credit this
Lions year) Your points
21. For each club that holds a Friendship
Night, Bring a Friend Night, LIONS Community Mixer or other club meeting
event that encourages new member growth 750 points each event Your points
22. For each club that has an
existing website or creates and maintains a new website that is linked
to LIONS clubs district-wide 1000 points (one time credit this
Lions year) Your points
23. For each club that has an
existing newsletter or creates and maintains a newsletter through
monthly/quarterly distributions linked/mailed to
LIONS clubs
district-wide 750
points one time credit for the newsletter and 100 additional points per
each month or quarter distribution ) 750 points (one time credit this
Lions year and 100 each month or quarter for
District-wide distribution ) Your points
24. For each club mailing of
the club's newsletter to your club members, the DG and the VDGs 100 points per each month or
quarter distribution ) 100 points per month or quarter Your points
25. For public service
announcements (P.S.A.) of each club event made through the local
newspaper, radio, television or other media management venue 50 points per event Your points
26. For each district
newsletter copied and distributed to club members monthly 100 points maximum per month Your points
27. For each club that
appoints a Club Visitation Chairperson 350 points (one time credit this
Lions year) Your points
28. For each club visitation
to another club (minimum of three (3) Lions, excluding district chairs
and officers on official business) 400 points each visitation Your points
29. For each club that has a brochure for
public distribution. A copy must be sent to the DG, the VDGs and
the Webmaster. 500 points (one time credit this
Lions year) Your points
30. For each newspaper article that is
printed and a copy is sent to the DG and the VDGs 100 points per article Your points
Community Service
31. For each club that
appoints a Community Betterment chairperson 350 points (one time credit this
Lions year) Your points
32. For each
county of clubs that
plants 300 or more trees by June 30, 2012 300 points
per club Your points
33. For each club that
sponsors or implements a cultural awareness program or project 300 points each event Your points
34. For each club that
develops a local community ALERT system (disaster plan) that identifies
club participation and roles 300 points (one time credit this
Lions year) Your points
35. For each club that
participates in a World Diabetes Day project, Helen Keller Day, World
Sight Day or other LIONS sight/hearing events in the community 300 points each event Your points
36. For each club that
sponsors a youth exchange or needy children's program/project in the
community 300 points per event Your points
White Cane Days held
Dates:
Amount
collected:
37. For each club that holds White Cane Days 300 points per event Your points
Eyeglasses recycled
Number of pairs:
38. For each club that
participates in eyeglass
recycling
100 points per month Your points
39. For each club that holds
an MTI event screening 500 points each event Your points
40. For sponsoring a Beacon Lodge Camper 500 points per camper Your points
41. For sponsoring any camper to a youth or
adult camp 500 points per camper Your points
42. For sponsoring a youth ball team or a
Scout troop, etc. 500 points (one time credit this
Lions year) Your points
43. For sponsoring the Drug Awareness or
Peace Poster Contest 300 points (one time credit per contest) Your points
44. For holding a Student of the Month recognition 200 points per student Your points
Little Ivy Jug participation
Amount collected
45. For Little Ivy Jug
participation 200 points each month Your points
46. For participation in community events
(parade, highway pick-up, etc.) 300 points each event Your points
Explanation of community
events:
47. For working with another
LIONS club on a project (to be titled and listed below)
400 points each event Your points
List
below what projects you worked on and with whom you shared the projects,
meetings attended and other statements to document the
points you claimed above.
Undocumented points will not be counted.
48. For working
with a professional agency or other community service organization to
serve the visually or hearing impaired or other community needed
services 400 points each event Your points
49. For submission of each
MADG report postmarked by the end of the current month 100 maximum points each
month Your points
Financial
50. For 100% donation to District Projects
at the time of the DG's visit, but no later than December 31, 2011 1,500 points (one time credit) Your points
51. For 100% donation to District Projects
by May 31, 2012 750 points (one time credit) Your points
52. For donations to Beacon Lodge Challenge
and the "500" Club 400 points each donation Your points
53. For other charitable donations,
excluding District Projects, per donation. These donations must be
listed below. Minimum donation is $50.00 200 points each donation Your points
To whom donated:
Donation amount
To whom donated:
Donation amount
To whom donated:
Donation amount
To whom donated:
Donation amount
To whom donated:
Donation amount
To whom donated:
Donation amount
54. For each
Melvin Jones Award given by the club 1000 points per award Your points
55. For each
Pennsylvania Fellow Award given by the club 500 points per award Your points
Attendance at Functions
56. For each Lion who attends a Region or
Zone meeting 200 points per Lion Your points
57. For each Lion who attends a
District Cabinet
meeting 400 points per Lion Your points
58. For each Lion who attends the Passing of
the Banner 400 points per Lion Your points
59. For each Lion who attends the Fall Rally
or Spring Convention 600 points per Lion Your points
60. For each Lion who attends a State
Council meeting or a State Convention 700 points per Lion Your points
61. For each Lion who attends the
International Convention 800 points per Lion Your points
62. For each Lion who attends the USA/Canada
Forum 800 points per Lion Your points
63. For each Lion who attends a Beacon Lodge
work weekend or Lions Appreciation Day 200 points per Lion Your points
