OFFICIAL VISIT SCHEDULING REQUEST FORM

For DG Robert Holliday, District 9x9

 

 

Club Name _________________________________________________

Contact Person ______________________________________________

Phone Number _______________________  Email _________________________

Meeting Place _______________________________________________________

Address ____________________________________________________________

City ____________________________

Meeting Time _________________  A.M. or P.M.

Visit Date __________________________________  (1st Choice)

                 __________________________________  (2nd Choice)

Are there any special topics that I should address?  ________________________________________________________________________________________________________________________________________________

 

Our club would like you to:

 

_____ Install new officers

_____ Induct new members

_____ Present awards (please specify what awards will be presented)  *

_____ Other:_________________________________________________

 

* __________________________________________________________

 

Please complete and return this form as soon as possible to:

 

DG Robert Holliday

2325 Elm Street

Davenport, IA  52803-2302

 

Or send the same information by email to:  YncCpo@aol.com

 

Please complete this form even if you have confirmed an official visitation date over the phone or in person.

 

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