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Michigan District of Key Club International

Annual Election Report Form


2016-2017
Information on this form will be published in the District Directory to be handed out in
November at Fall Rally unless otherwise requested.
Club _____________________________________________ Division __________________
School Address
City, Zip code ____________________________________ Telephone ________________
Meeting Time (Day, hour) _________________________ Meeting Place ____________
Principal______________________________ Phone Number_______________________
Sponsoring Kiwanis Club______________________________________________________
President ____________________________________________________________________
Telephone________________________________________ Email _____________________
Vice-President _______________________________________________________________
Telephone________________________________________ Email _____________________
Secretary____________________________________________________________________
Telephone________________________________________ Email _____________________
Treasurer ____________________________________________________________________
Telephone________________________________________ Email _____________________
Bulletin Editor ________________________________________________________________
Telephone________________________________________ Email _____________________
Faculty Advisor ______________________________________________________________
Telephone________________________________________ Email _____________________
Kiwanis Advisor ______________________________________________________________
Telephone_________________________________________Email____________________

Please fill out and return this form to the District Secretary via e-mail:
secretary@mikeyclub.org. A copy should also be sent to your respective Lt. Governor.
Elections should be held in early February.

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