Club Name:

Division : (Select Division) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Report for the month of: (Select Month) January February March April May June July August September October November December Summer

Was your club contacted by your LTG: Yes No

How was your club contacted by your LTG: Email Visit Newsletter Phone

Was your club contacted by your Kiwanis Club/Advisor this month: Yes No

How was your club contacted by your Kiwanis Club/ Advisor: Email Visit Newsletter Phone

Total hours of service for this month:

Would you like to send this MRF to your Sponsoring Kiwanis Club: Yes

Message to Kiwanis Club

President:

Faculty Advisor:

Secretary: