PNW CKI District Monthly Report
Welcome to the District Monthly Report form, created by the Pacific Northwest District of Circle K International! If you are currently a club secretary in the PNW District, our district specifically asks that you complete both the International Monthly Report form, as well as this District MRF.

This form is similar to the International MRF, however, we want to understand your club's accomplishments, problems, solutions, and goals on a smaller scale. This form is dedicated to bridging a stronger relationship between clubs and the district board. We want to be a support system for you, and we cannot do that without your consistent participation and communication.

If you have any questions, comments, or concerns, please contact Lieutenant Governor-at-Large Shane Petrus at shane.petrus@wsu.edu, or visit www.pnw-cki.org today.
Secretary Full Name *
Your answer
Home Club *
Email Address *
Your answer
Phone Number *
Your answer
Member ID # *
Your answer
Number of Service Hours Completed *
Your answer
Number of Interclubs Completed *
Your answer
Number of K-Family Relation Events *
Your answer
Service Partners/Charities of the Month *
Your answer
Average Number of Attendees per meeting *
Average Number of Attendees per Service Event *
Please explain any goals completed this month *
Please cite any club/officer goals that were accomplished this month. Examples include: service hours, high attendance, officer achievements, etc.
Your answer
How would you rate your club engagement this month? *
Extremely Low
Very High
How would you rate your club attendance this month? *
Extremely Low
Very High
What is one thing your club wants to improve upon and why? *
Your answer
Please ensure all information above is accurate.
Please type your full name as a signature. By signing below, you agree that all of the information contained in this form is accurate and up-to-date. If there are any changes to be made to your submission, please contact District Secretary Sruti Nagalla at pnwckidistrictsecretary@gmail.com or Lieutenant Governor-at-Large Shane Petrus at shane.petrus@wsu.edu.
Signature *
Your answer
Date Submitted *
MM
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YYYY
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