2010 - 2011 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 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    Work Telephone  Fax 
Email Address  Spouse's Name
Secretary's Name             Member Number            
Secretary's Street Address  
City             State             Zip            
Home Telephone    Work Telephone  Fax 
Email Address  Spouse's Name 
Treasurer's Name             Member Number            
Treasurer's Street Address  
City             State             Zip            
Home Telephone    Work Telephone  Fax 
Email Address  Spouse's Name 
Membership Chairperson's Name             Member Number            
Membership Chairperson's Street Address  
City             State             Zip            
Home Telephone    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.

Back to Home