UNICO National Monthly Chapter Report

Instructions: Complete report monthly

* indicates a required field

* For the month of:

* Date Submitted:

* District:

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* Chapter:

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Membership Report

* Total Members, from
7/1 Dues Billing Report:

* No. of Members from
Previous Month Report:

No. of New Members
This Month:

No. of Members
Dropped This Month:

* Membership Total
at End of Month:

Total Change From
Previous Month (+/-):

No. of Members Who
Attended Meeting:

% of Total Members
in Attendance:

Chapter Activity Report

Expansion Leads

Full Name of
Person to Contact:

Address:

City:

State:

Zip Code:

Completed By

* Submitted by:

* Title:

* Email Address:

Please send copy to: (optional)

Name:

Email Address:

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