Membership
report
OUTHOUSES
ONLY!
Of
Clan
For
period Ending
March
31st:
E-mail
Address of Outhouses:
Snail
Mail Address:
Your
current initiation fee
(Includes
Imperial registration fee of $10)
Fee
is $
Total
membership as of date above:
(Attach
list of new members since last report)
Raban
of Outhouse:
Keeper
of the Cob:
Guardian
of Still
Meeting
location and times:
Application for Charter in
Grand and Glorious Order of the Hillbilly Degree, Item 4, is an agreement to
turn in profits Annually to Shriners Hospitals for Children and Shriners Burns
Institute or Transportation Fund!
Total
Donated from prior years
$
Total
Donated this year
$
Items
Purchased for Hospitals
. $
Use space below to list
time and place of dances, Initiations, and other special events Past or
Future and Where Donations Made!
__________________________________________________________________________________________________________
Click
here to enter text.
________________________________________________________________________________________________Please attach a list of ALL new members for the year
of this report click next and select
your Main clan e-mail to send!
_________________________________________________________________________________________________
Preparer: Click
Next!