RuritanClubandDistrictOfficersHandbook
Ruritan National Form R-4 Community Service Committee Report
YEAR 2021
Period Beginning September 1
Period Ending August 31
2022
District Governor Aproval (initials and date) ________ ________
Community Engagement Largetown Ruritan Club
Club Name:
Committee:
NOTE: Include Associate members in these numbers if you plan to include their hours below.
Number of active members in September Number of active members in August
71
69
Please provide an official copy to the district governor and keep a copy for your club files
Active Member Hours
Project
If
your text is too long for the cell provided below it will automatically shrink the text size to fit.
Dollars Spent
1 2 3 4 5 6 7 8 9
Worked with local industry to hire permanent workers Helped sponsor a local job fair ‑ paid for refreshments Recognized outstanding business leaders with an award Sponsored a 4‑H dairy livestock judging contest Sponsored an FFA award at the local high school
240 150
$75.00 $250.00 $200.00 $245.00 $800.00
20
250
18
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
Grand Totals
678
$1,570.00
I certifiy this to be a true and accurate report. At least two club officers must sign and date this document on the lines below. A
Tony Wilson, Secretary
Club officer's name, title, and date signed
Jason Jones, Treasurer
Club officer's name, title, and date signed
This section below will self‑complete as the numbers are entered above. Once all the projects are entered, put the total number in the yellow box below. District officers will need to verify the computations. If you failed to enter your September and August active membership at the top of the page, the calculations will not compete.
The membership numbers for September and August listed at the top of this form have been added together and divided by 2 to get the average number of active members shown below.
Points
Number of Projects Number of Hours
5 x
2 = 5 =
10.00
Average
678 x
3390.00 3925.00
70
Number of Dollars $1,570.00 x
2.5 =
Special Note (revised August 2005) You may count the hours worked by Associate Members, however you must also count them in the number of members divided into those hours
Divided by average number of Active Club Members (from box at right) Total Points Above
7325
Total points per member
104.64
87
Revised 8/2021
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