Officer Change Form

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CHANGE OF CLUB OFFICER FORM
Use this form only if you have a change of officers after you have
filed your Annual Roster Report.
Please type or print.
Club Name_____________________________________________________________________
Club Code_______________________Region_________________________________________
CURRENT OFFICERS:
President__________________________________________Membership#__________________
Address________________________________________________________________________
City, State, Zip__________________________________________________________________
Phone (_____) __________________________________________________________________
E-Mail _________________________________________________________________________
Treasurer___________________________________________Membership#________________
Address________________________________________________________________________
City, State, Zip__________________________________________________________________
Phone (_____) __________________________________________________________________
E-Mail _________________________________________________________________________
NEW OFFICERS:
President____________________________________________Membership#________________
Address________________________________________________________________________
City, State, Zip__________________________________________________________________
Phone (_____) __________________________________________________________________
E-Mail _________________________________________________________________________
Treasurer_____________________________________________Membership#______________
Address________________________________________________________________________
City, State, Zip__________________________________________________________________
Phone (_____) __________________________________________________________________
E-Mail _________________________________________________________________________
Date: _________________________Signature:_________________________________________
For confirmation please include a self addressed stamped envelope.
H:\Membership\Forms\Change of Club Officers Form.doc
8/22/2007

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