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District Information
 
for 2009 -2010 Directory
   
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This information should be completed by 1st April 2009
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District Information
District No:   State:
No of Clubs in District :   << Please leave blank
Please enter details for Chairman
First Name: Last Name:
Partner: Address:
Suburb: Postcode:
Club:    
Phone number format: nn nnnn nnnn       Mobile format: nnnn nnn nnn
Phone: Fax:
Email Address Mobile:
       
Please enter details for Vice Chairman
First Name: Last Name:
Partner: Address:
Suburb: Postcode:
Club:    
Phone number format: nn nnnn nnnn       Mobile format: nnnn nnn nnn
Phone: Fax:
Email Address Mobile:
Please enter details for Jnr Vice Chairman
First Name: Last Name:
Partner: Address:
Suburb: Postcode:
Club:    
Phone number format: nn nnnn nnnn       Mobile format: nnnn nnn nnn
Phone: Fax:
Email Address Mobile:
Please enter details for Imm Past Chairman
First Name: Last Name:
Partner: Address:
Suburb: Postcode:
Club:    
Phone number format: nn nnnn nnnn       Mobile format: nnnn nnn nnn
Phone: Fax:
Email Address Mobile:
Please enter details for Secretary
First Name: Last Name:
Partner: Address:
Suburb: Postcode:
Club:    
Phone number format: nn nnnn nnnn       Mobile format: nnnn nnn nnn
Phone: Fax:
Email Address Mobile:
Please enter details for Treasurer
First Name: Last Name:
Partner: Address:
Suburb: Postcode:
Club:    
Phone number format: nn nnnn nnnn       Mobile format: nnnn nnn nnn
Phone: Fax:
Email Address Mobile:
Please enter details for International
First Name: Last Name:
Partner: Address:
Suburb: Postcode:
Club:    
Phone number format: nn nnnn nnnn       Mobile format: nnnn nnn nnn
Phone: Fax:
Email Address Mobile:
Please enter details for Extension
First Name: Last Name:
Partner: Address:
Suburb: Postcode:
Club:    
Phone number format: nn nnnn nnnn       Mobile format: nnnn nnn nnn
Phone: Fax:
Email Address Mobile:
Please enter details for Historian
First Name: Last Name:
Partner: Address:
Suburb: Postcode:
Club:    
Phone number format: nn nnnn nnnn       Mobile format: nnnn nnn nnn
Phone: Fax:
Email Address Mobile:
Please enter details for Social Convenor
First Name: Last Name:
Partner: Address:
Suburb: Postcode:
Club:    
Phone number format: nn nnnn nnnn       Mobile format: nnnn nnn nnn
Phone: Fax:
Email Address Mobile:
Please enter details for Editor
First Name: Last Name:
Partner: Address:
Suburb: Postcode:
Club:    
Phone number format: nn nnnn nnnn       Mobile format: nnnn nnn nnn
Phone: Fax:
Email Address Mobile:
 
Please enter details for Council Member
First Name: Last Name:
Partner: Address:
Suburb: Postcode:
Club:    
Phone number format: nn nnnn nnnn       Mobile format: nnnn nnn nnn
Phone: Fax:
Email Address Mobile:
 
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Last modified: 16/12/2008 9:59:51 AM