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2018-2019 NYDKC Election Report Form
Fill in N/A if position is not held in your school.
DO NOT write school phone numbers for officers.
DO NOT fill this out for the next service year (April 2019 onwards)
DO NOT write multiple officers in one field, there is an option to add more positions.

USE THE EXACT NAME LISTED HERE:
https://docs.google.com/document/d/1BR58nUN3aof_T_j1ZcRO999qYxxeGDwtG4XbXppHSQ8/edit?usp=sharing

If you have any questions, feel free to contact me
__________
District Secretary
Peter Alegre
alegrep@bxscience.edu
646-745-4512

Email address *
Club Name *
This is the name of your high school typically, unless you belong to a community club. DO NOT write "Key Club" USE THE EXACT NAME LISTED HERE: https://docs.google.com/document/d/1BR58nUN3aof_T_j1ZcRO999qYxxeGDwtG4XbXppHSQ8/edit?usp=sharing
Your answer
Division *
LTG Information
Divisions 7, 14, 17, 22 - Select liaison@nydkc.org
Contact Information
Please use emails and phone numbers that are easily accessible.
Faculty Advisor Name *
Your answer
Faculty Advisor Email *
Your answer
Faculty Advisor Phone Number *
Your answer
Do you know who your Kiwanis Advisor is? *
If you are not sure, this is found in the Membership Update Center, (MUC) which is where dues are paid. Depending on who has access to the MUC, they can find out there. If your club has trouble paying dues or can't access the MUC, please contact me.
Kiwanis Advisor Name *
Your answer
Kiwanis Advisor Email *
Your answer
Kiwanis Advisor Phone Number *
Your answer
President Name *
Your answer
President Email *
Your answer
President Phone Number *
Your answer
Vice President Name *
Your answer
Vice President Email *
Your answer
Vice President Phone Number *
Your answer
Secretary Name *
Your answer
Secretary Email *
Your answer
Secretary Phone Number *
Your answer
Treasurer Name *
Your answer
Treasurer Email *
Your answer
Treasurer Phone Number *
Your answer
Webmaster Name *
Your answer
Webmaster Email *
Your answer
Webmaster Phone Number *
Your answer
Bulletin Editor Name *
Your answer
Bulletin Editor Email *
Your answer
Bulletin Editor Phone Number *
Your answer
Do you have additional positions to report? *
This includes co-officers such as presidents and secretaries. If you have more than one advisor, report so here.
Questions, Comments, Concerns?
Leave blank if there are none
Your answer
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