CT Elks State/District Chairperson Contact Information Update form
If you've become a new State or District Chairperson, please fill this out. Also if your contact information has changed, please enter it in this form.
Name and Elks Titles (PER, PSP, etc.)
Your answer
Committee Name (if on multiple committees, fill this form out multiple times.)
Your answer
State or District Chair?
Email address
Your answer
Phone number
Your answer
Mailing address
Your answer
Home Lodge and number
Your answer
Any additional information you wish to provide
Your answer
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