New York District Key Club

Lt. Governor's Club Visitation Form

Please complete this form within TWO DAYS of your club visit.

IF YOUR PAGE COMES OUT BLANK/WHITE AFTER YOU CLICK SUBMIT IT MEANS YOU MISSED A REQUIRED FIELD OR THAT YOU DON'T HAVE AT LEAST 20 CHARACTERS IN YOUR BIG TEXT BOXES.

Lieutenant Governor *

Division *

Lieutenant Governor's E-Mail *

Key Club Of *

Date of Visit *

Please give brief description of meeting *

Did you make brief presentation of any kind? *

If yes, please describe

Has the club paid dues for all it's members? *

Is the club active on division & district levels? *

Please explain for the above *

What are the club's strengths? *

What are the club's weaknesses? *

Approved by: * Lt. Governor
Respective Club President