List Of Lodge Officers

FORM MUST BE SUBMITTED TO THE MEMBER BENEFITS DEPARTMENT BY DEC. 15.

    Lodge Name

    Choose Report Year

     

    President Name

    Phone Number

    Email

    Street Address

    City

    State

    Zip / Postal Code

     

    Vice President Name

    Phone Number

    Email

    Street Address

    City

    State

    Zip / Postal Code

     

    Financial Secretary Name

    Phone Number

    Email

    Street Address

    City

    State

    Zip / Postal Code

     

    Corresponding Secretary Name

    Phone Number

    Email

    Street Address

    City

    State

    Zip / Postal Code

    Financial Trustee 1 Name

    If elected for a three-year term, what year was the election?

    Phone Number

    Email

    Street Address

    City

    State

    Zip / Postal Code

     

    Financial Trustee 2 Name

    If elected for a three-year term, what year was the election?

    Phone Number

    Email

    Street Address

    City

    State

    Zip / Postal Code

     

    Financial Trustee 3 Name

    If elected for a three-year term, what year was the election?

    Phone Number

    Email

    Street Address

    City

    State

    Zip / Postal Code

    APPOINTED/ADDITIONAL OFFICERS (optional)
    POSITION/TITLE

    Name

    Phone Number

    Email

    Street Address

    City

    State

    Zip / Postal Code

     

    POSITION/TITLE

    Name

    Phone Number

    Email

    Street Address

    City

    State

    Zip / Postal Code

     

    POSITION/TITLE

    Name

    Phone Number

    Email

    Street Address

    City

    State

    Zip / Postal Code

     

    POSITION/TITLE

    Name

    Phone Number

    Email

    Street Address

    City

    State

    Zip / Postal Code

     

    POSITION/TITLE

    Name

    Phone Number

    Email

    Street Address

    City

    State

    Zip / Postal Code

    Please select how often your lodge meets

    MonthlyBi-monthlyQuarterlyOther

    If bi-monthly, quarterly or other, please list which months meetings are held

    Meeting day

    Meeting time

    Meeting location

    Street Address

    City

    State

    Zip / Postal Code

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