High Twelve International, Inc.
F-200b Club or Association Officer or Meeting Location Report Form
For Reporting Changes 

UPDATED Club Meeting Information

Items with an * are REQUIRED!

Select 1 HTI ZONE Officer for your STATE or COUNTRY This will be a Required Field **

Rick Santella, President RICK@HIGH12.ORG
     Zones: DC, HI, JP, ME, UK, Brazil, Presidents Club
Roberto M. Sanchez, 1st VP ROBERTO@HIGH12.ORG
     Zones: MO, NCA, FL, AZ
Jared Kichline, 2nd VP JARED@HIGH12.ORG
     Zones: NJ, MI, OH, KS, IN, TX
Conrad Dombkiewicz, 3rd VP DARRIN@HIGH12.ORG
     Zones: CA, CO, PA, LA, IL

** Select ONE email
Change is for: *

UPDATED Officer Information (up to 255 characters can be entered for each comment field)

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Additional Comments

0/400 characters

You will receive a detailed email of your submission automatically. You can also send up to 3 additional copies of this submission to anyone you choose.

If required fields  *  are not filled out
you cannot submit the form until corrected.

Missing or incorrect information will be marked in RED.
To be filed only when there is a change in club meeting or officer information.
It is not necessary to USMail a copy of this form to the International Office!
High Twelve International, Inc.
PO Box 2363
Sun City AZ 85372-2363
All rights reserved 2014-24