Monadnock Lions Club

Member Information

Name:

Month/Day/Year of birth:

Home town:

State:

Current address:

City:

State:

ZIP Code:

Phone:

Years at your current address?

E-Mail :

Favorites

Places to travel:

Beverage:

Color:

Childhood TV program

Ice cream:

Food:

Movie of all time

Music decade:

Season:

First car owned:

Smell:

Memberships

Organizations other than Lions:

Positions held:                                                   Years:          Position Held:                                                   Years:

schooling

High School graduated from:

Post Education:  Yes    No   (please circle)

College:

Major:                       Degree:

school and community

Positions held:                                                   Years:          Position Held:                                                   Years:

Positions held:                                                   Years:         

 High School sports

College sports

Favorite subject

Clubs:

Fraternity:

Family

Married   Single    (please circle)

If married how many years

How Many Children:

How many grand children

How many great grand children

Hobbies and Talents

Why I became a Lion