Ruritan National Secretary's Handbook

New Club Officers Information _______________________________ Year

Club Name: ______________________________________________________ Notice to Club Secretary:

Computer Number: _________________

The information on this form is included as part of the official roster of clubs and officers recognized by the Internal Revenue Service in granting federal tax exemption for Ruritan clubs. It is important that we receive this report from you IMMEDIATELY . If possible, please mail this form postmarked by November 10. _____________________________ of each month (day of the week your club meets) Employer Identification Number (EIN): ______________________ Website (if applicable): ______________ Physical Location of Club (for mapping purposes please provide the street address for club building or meeting place, including city, state, and zip code) : __________________________________________________ Regular Club Meeting Time and Day: : __________________________________________________ Regular Meeting: [ ] First [ ] Second [ ] Third [ ] Fourth

District Name and Number: _ __________________________________________________ Zone Number: _ ________________

Club President: _ ____________________________________________________________ Phone ( ) _ _________________

Mailing Address ___________________________________________________E-mail address_________________________

City_____________________________________________ State_ ___________________ ZIP Code______________________

Vice President: _ ____________________________________________________________ Phone ( )___________________

Mailing Address ___________________________________________________E-mail address_________________________

City _ ___________________________________________ State____________________ ZIP Code______________________

Club Secretary: _ ____________________________________________________________ Phone ( )___________________

Mailing Address ___________________________________________________E-mail address_________________________

City_____________________________________________ State ____________________ ZIP Code_ ____________________

Treasurer: _ ________________________________________________________________ Phone ( )___________________

Mailing Address ___________________________________________________E-mail address_________________________

City _ ___________________________________________ State_ ___________________ ZIP Code______________________

Past President: _ ____________________________________________________________ Phone ( )___________________

Mailing Address ___________________________________________________E-mail address_________________________

City _ ___________________________________________ State_ ___________________ ZIP Code______________________

Director 3rd Year: _ __________________________________________________________ Phone ( )___________________

Mailing Address ___________________________________________________E-mail address_________________________

City _ ___________________________________________ State_ ___________________ ZIP Code______________________

Director 2nd Year: ___________________________________________________________ Phone ( )___________________

Mailing Address ___________________________________________________E-mail address_________________________

City _ ___________________________________________ State_ ___________________ ZIP Code______________________

Director 1st Year: _ __________________________________________________________ Phone ( )___________________

Mailing Address ___________________________________________________E-mail address_________________________

City _ ___________________________________________ State_ ___________________ ZIP Code______________________

Send copies to District Governor, District Lt. Governor, Zone Governor, and National Rep. Retain one copy for your club files as shown. Please send this copy to the National Office POSTMARKED by the 10th of November.