PU-101

2022-2023 Lions Club Officers

2022 - 2023 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 Number and Member Numbers can be found on the semi-annual per capita form

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
Club Administrator's Name	Member Number
Club Administrator'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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