Club Monthly Membership Summary Rev 9/25/23

Items with an ** are REQUIRED!

Today's Date * * +

Month Being Reported * *

Club Number * *

Your Name * *

Your email address * *

State Association Secretary Email

Additional Copy To:

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
Darrin Pitts, 2nd VP DARRIN@HIGH12.ORG
     Zones: CA, CO, PA, LA, IL
Jared Kichline, 3rd VP JARED@HIGH12.ORG
     Zones: NJ, MI, OH, KS, IN, TX

*

	rick@high12.org	roberto@high12.org	darrin@high12.org	jared@high12.org
** Select ONE email	rick@high12.org	roberto@high12.org	darrin@high12.org	jared@high12.org

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	Prior EOM	+ New	+ Reinstated	- Dropped	= EOM Total

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	Prior EOM	+ New	+ Reinstated	- Dropped	= EOM Total

End of Month Total Membership [Regular plus Masonic Home]

End of Month Membership Summary ** *

	+ Regular Members	+ Masonic Home Members	= Total CLUB Membership
Grand Total =	+ Regular Members	+ Masonic Home Members	= Total CLUB Membership

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.

No changes to be reported this month.

Weekly Attendance - optional

Enter Weekly Attendance

	Wk 1	Wk 2	Wk 3	Wk 4	Wk 5
Members	Wk 1	Wk 2	Wk 3	Wk 4	Wk 5
Guests	Wk 1	Wk 2	Wk 3	Wk 4	Wk 5

Supplemental Membership Information - provide name address, phone numbers and EMAIL ADDRESS! For adds and drops include effective date!

#1 Type of Change

#1 New Member Recommended By:

#1 Member details here: [name, address, email, phone(s), date (joined/reinstated/dropped/died]

0/225 characters

#2 Type of change

#2 New Member Recommended By:

#2 Member member details here: [name, address, email, phone(s), date (joined/reinstated/dropped/died]

0/225 characters

#3 Type of change

# 3 New Member Recommended By:

#3 Member details here: [name, address, email, phone(s), date (joined/reinstated/dropped/died]

0/225 characters

#4 Type of change

#4 New Member Recommended By:

#4 Member details here: [name, address, email, phone(s), date (joined/reinstated/dropped/died]

0/225 characters

#5 Type of change

#5 New Member Recommended By:

#5 Member details here: [name, address, email, phone(s), date (joined/reinstated/dropped/died]

0/225 characters

#6 Type of change

#6 New Member Recommended By:

#6 Member details here: [name, address, email, phone(s), date (joined/reinstated/dropped/died]

0/225 characters

#7 Type of change

#7 New Member Recommended By:

#7 Member details here: [name, address, email, phone(s), date (joined/reinstated/dropped/died]

0/225 characters

#8 Type of change

#8 New Member Recommended By:

#8 Member details here: [name, address, email, phone(s), date (joined/reinstated/dropped/died]

0/225 characters

#9 Type of change

#9 New Member Recommended By:

#9 Member details here: [name, address, email, phone(s), date (joined/reinstated/dropped/died]

0/225 characters

#10 Type of change

#10 New Member Recommended By:

#10 Member details here: [name, address, email, phone(s), date (joined/reinstated/dropped/died]

0/225 characters

Additional Comments

Enter any additional comments or information here - 125 character limit!

0/400 characters

You and your Association Secretary OR HTI President 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 information will be marked in RED.

Make your payment via Affinipay (no account needed) of $5.00 for each new or reinstated member by clicking the link below - PLEASE enter your club number and name in "reference line" under the dollar amount to pay:

High Twelve International Inc.
Fee Payment