High Twelve International, Inc.
F-200a Monthly Report Form
For Reporting Changes In Membership

Club Monthly Membership Summary Rev 3/26/24

Items with an ** are REQUIRED!
 +
PLEASE do not CC the HTI Secretary as he gets a copy automatically when you click on submit!

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

Roberto M. Sanchez, President RICK@HIGH12.ORG
     Zones: DC, HI, All Foregin Clubs,  Presidents Club
Jared Kichline, 1st VP ROBERTO@HIGH12.ORG
     Zones: NCA, IN, KS, MO Indp, AZ Indp,
Terry Hills, 2nd VP JARED@HIGH12.ORG
     Zones: TX, CO, LA, IL, CA Indp.
Benjamin Castellamare, 3rd VP Ben@HIGH12.ORG
     Zones: PA, MI, OH, FL, NJ Indp.
 *
 roberto@high12.orgjared@high12.orgTerry@high12.orgBen@high12.org
** Select ONE email

All membership number fields are REQUIRED (**) REGULAR Membership

Regular Members - are those members   NOT   living in a Grand Lodge sponsored facility * *
 Prior EOM+ New+ Reinstated- Dropped= EOM Total
Regular Members

MASONIC HOME Membership

Masonic Home Members - are those members that   DO   live in Grand Lodge sponsored facility * *
 Prior EOM+ New+ Reinstated- Dropped= EOM Total
Masonic Home Members

End of Month Total Membership [Regular plus Masonic Home]

End of Month Membership Summary * *
 + Regular Members+ Masonic Home Members= Total CLUB Membership
Grand Total =
If there are NO additional changes [adds, drops, address/email updates] to report this month, check the box, scroll to the bottom, click on continue; confirm, you are done.

Weekly Attendance - optional

Enter Weekly Attendance
 Wk 1Wk 2Wk 3Wk 4Wk 5
Members
Guests
Donations - Financial and Time
 WolcottDeMolayJob'sRainbow
Dollars
Time

Supplemental Membership Information - provide name address, phone numbers and EMAIL ADDRESS, include effective date! For drops it is sufficient provide the membership # only.

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Additional Comments

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You and your Association Secretary or HTI President and HTI Zone Officer 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.

Make your $5 per member payment via PayPal before clicking on submit below. You will be returned to this page when payment window/page is closed by you.  If no payment is due just click on submit.

No PayPal account needed!
Just click on the black button for Debit - Credit Cards

High Twelve International Inc. Member Fee Payment

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Any F-200a required  **  fields that are not filled out correctly
will b
e marked in RED, make corrections and submit again.
Secured by Formsite
To be filed after the last meeting of the month, each month.

New & Reinstated Members - pay online $5.00 per member.
 
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
623.239.6170
www.high12.org
All rights reserved 2014-24