Please complete the form below. Your information will be forwarded to your Area Vice President.
Information marked with a red star is required.
Name:
District Number:
Email:
Phone: (optional)
Total Members in District:
Total Members Added:
Total Members Lost:
Total Members At-Large:
Have you contacted three current chapters?
Please list each chapter, contact person, date contacted and results of your contacts.
Have you contacted three prospective chapters?
Have you contacted three weak or dormant chapters?
Number of Social Activities This Reporting Period:
Number of District Board of Directors Meetings:
Number of Membership Meetings:
Does your district publish a newsletter?
If YES, please send your Area VP a copy of the newsletter by mail or email, or list the web address of the newsletter here:
If your District has a website, please list the web address here:
Please list any contacts with the International Operations Center and your comments about their service:
Please list any contacts with Commodore Insignia and your comments about their service:
Please list any contact with your Area Vice-President and your comments about his/her service:
Does your district receive The Blue Gavel Log in a timely manner?
Does your district have an IOBG Auxiliary?
If No, please provide a phone number if you would like an IOBG Auxiliary officer to contact you:
Please list any contact or activity with the IOBG Humanitarian Foundation during this reporting period:
Please list contact information for your district's Alternate Director
Send me a copy of this report
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IOBG NORTHWEST DISTRICT DIRECTOR'S REPORT