Cart
0
About Us
National Charity
Directory
Resources
Store
Join us
Contact
DONATE NOW
Back
What We Do
National Presidents Message
History
Projects
Programs
National Convention
Back
About Our National Charity
Speech and Hearing Month
Emily's Journey
Personal Donations
Memorial Donations
Tribute/In Honour Donations
Hi-Five Club
Donate Now
Back
Lodges
Associations
National Executive
National Office
National Committees
PGER
Back
Resource Centre
Canadian Elk
Elks Proud Blog
Elks Proud Awards
Back
Store Homepage
Lodge Materials
Regalia
Fund for Children
Cart
0
About Us
What We Do
National Presidents Message
History
Projects
Programs
National Convention
National Charity
About Our National Charity
Speech and Hearing Month
Emily's Journey
Personal Donations
Memorial Donations
Tribute/In Honour Donations
Hi-Five Club
Donate Now
Directory
Lodges
Associations
National Executive
National Office
National Committees
PGER
Resources
Resource Centre
Canadian Elk
Elks Proud Blog
Elks Proud Awards
Store
Store Homepage
Lodge Materials
Regalia
Fund for Children
Join us
Contact
DONATE NOW
Grand Lodge Directory Report Form
Lodge Name & No.
*
PLEASE GIVE INSTALLATION DATE OF LODGE OFFICERS:
MM
DD
YYYY
Section 1: EXALTED RULER / PRESIDENT
Lodge Officer
Exalted Ruler
President
Exalted Ruler / President - Name
First Name
Last Name
Spouses Name (optional)
First Name
Last Name
Master No.
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone #
(###)
###
####
Fax #
(###)
###
####
Email
Section 2: SECRETARY
Secretary Name
First Name
Last Name
Secretary's Spouse Name (optional)
First Name
Last Name
Master No.
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone #
(###)
###
####
Fax #
(###)
###
####
Email
Section 3: ADDRESS OF LODGE OR FACILITY USED FOR MEETINGS
Name of Hall or Facility
Hall/Facility Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone of Hall/Facility
(###)
###
####
Website
if applicable
http://
Lodge Email Address
if applicable
Does Lodge Have A Lounge?
Yes
No
Lounge Phone #
if applicable
(###)
###
####
Lodge Meeting Nights & Times
Lodge Correspondence Should Be Sent to:
Secretary Address As Indicated In Section 2
Lodge/Facility Address As Indicated In Section 3
Would you like to receive accounting forms (ie. invoices, statements, etc) via email?
Yes
No
Email (if indicated yes above)
Section 4: PUBLICITY DIRECTOR
Publicity Director Name
First Name
Last Name
Master No.
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone #
(###)
###
####
Email
Section 5: LODGE CHARITIES COMMITTEE CHAIRMAN
Name
First Name
Last Name
Master No
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
(###)
###
####
Email
Section 6: LODGE MEMBERSHIP CHAIRMAN
Name
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
(###)
###
####
Email
Thank you!