5 -2012-2013 Blank Roster Form

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NEW JERSEY DISTRICT OF KEY CLUB I NTERNATIONAL 2012-2013 CLUB OFFICER ROSTER All clubs are expected to hold elections for the 2012-2013 year prior to the District Convention or as soon as possible after. This is important so that the new officers can receive proper training. For those clubs that have not submitted a club roster, please mail or email this form ASAP. We need this information to communicate with you. Information submitted will only be used for communication purposes with the Kiwanis Family. Key Club of ___________________________________________ Sponsoring Kiwanis Club ____________________________________________________________ School ____________________________Address ______________________________________________________________________________________________ Phone _____________________ _____________________ __________________Prin cipal’s Name _____________________________________________ _________ Faculty Advisor Name_______________________________ Mailing Address:________________________________________________________________________ Faculty Advisor Email ____________________________________________________ Phone No._________________________________________ Gender: ______ Kiwanis Advisor Name_______________________________ Mailing Address:________________________________________________________________________ Kiwanis Advisor Email ____________________________________________________ Phone No._________________________________________ Gender: ______ Office President Vice President Secretary Treasurer Editor Name Street City, Zip Code Phone No. Email Grad. Year Gender EMAIL IN AN EXCEL DOCUMENT TO [email protected]

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NEW JERSEY DISTRICT OF KEY CLUB INTERNATIONAL2012-2013 CLUB OFFICER ROSTER 

All clubs are expected to hold elections for the 2012-2013 year prior to the District Convention or as soon as possible after. This is important so that the newofficers can receive proper training. For those clubs that have not submitted a club roster, please mail or email this form ASAP. We need this information tocommunicate with you. Information submitted will only be used for communication purposes with the Kiwanis Family.

Key Club of ___________________________________________ Sponsoring Kiwanis Club ____________________________________________________________

School ____________________________Address ______________________________________________________________________________________________

Phone ____________________________________________________________Principal’s Name ______________________________________________________

Faculty Advisor Name_______________________________ Mailing Address:________________________________________________________________________

Faculty Advisor Email ____________________________________________________ Phone No._________________________________________ Gender: ______

Kiwanis Advisor Name_______________________________ Mailing Address:________________________________________________________________________

Kiwanis Advisor Email ____________________________________________________ Phone No._________________________________________ Gender: ______

Office President Vice President Secretary Treasurer Editor

Name

Street

City, ZipCode

PhoneNo.

Email

Grad.Year

Gender

EMAIL IN AN EXCEL DOCUMENT [email protected]