Identification

1. Reporting for the month of

2. District Governor

3. District

Club Meetings Attended

4. Regular Meetings

5. Board Meetings

6. Special Meetings

7. Clubs Visited/Occasion/Date

8. Special Remarks - Do clubs need assistance from RSD's, RDE, RD, or AP?

Copies of this report will be sent automatically by email to RD, RDE, and Reg. Sec. upon submission.