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Alumni Chapter Annual Report Form

Lincoln University (MO) Alumni Association

Please prepare in triplicate ( type or print) and return one copy prior to December 31 of each year to the Office of Alumni Affairs at Lincoln University; One copy to the Alumni Association National Secretary, and keep one for your files.

Report Year

Name of Chapter

Date Organized

Address

City

State

Zip Code

Chapter Officers
(include name, address, city, state, phone, email)

President
Vice-President
Secretary
Treasurer

Term of office for the listed officers expires

Chapter Five-Year Membership Trend

	Year	Year	Year	Year	Year
Approximate number of alumni in your area
Approximate number of chapter members
National dues remitted to the Association	$	$	$	$	$
Chapter contributions remitted to the university	$	$	$	$	$

These items have been submitted to the Office of Alumni Affairs at Lincoln University

Chapter Constitution

Date Submitted

Roster of Active Members

Date Submitted

If the items above have not been submitted, please indicate the date it will be mailed

Chapter annual dues per member $

Regular chapter meeting date Meeting Location

Chapter activities and projects sponsored this year

Report prepared by

Date prepared

Office

Telephone Number