Assistant Governor Visit Form
Please fill out this form for every visit with your clubs.
Date of Visit *
MM
/
DD
/
YYYY
Club Name *
Your answer
Your Name *
Your answer
Your Email Address
Your answer
Your Lieutenant Governor
Type of Visit
Important Events (upcoming and past)
Your answer
Existing Challenges
Your answer
Efforts to Increase Membership/Results
Your answer
Service Project Involvement
Your answer
Your Sense of the club during visit
Your answer
How were you received during your visit
Your answer
Items DG or Staff could assist with/follow up
Your answer
Additional Comments
Your answer
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