Club Info


	Web Site Design Form for Club

Club Name: _____________________	No. ___
Date Club Institued________

Colors you prefer : ___________

Style: ______________________

(Floral, American, Victorian, Angels, Animals, Etc)

President Name: __________

Year: ___________________

Color: ___________________

Symbol: _________________

Flower: _________________

Song: ___________________

Theme: _________________

Charity: _________________

Pin: ____________________




	This Space may be used for a Photo of Officers or Club President.

The ________________________ Club meets

on the ________ of every month at _______

am/pm, with the exception of _____ and ___

when the Club is dark. Our Emblem Club Meetings

are held at the following Elks Lodge location:

Elks Lodge Name & No: _______________________

Address: ___________________________________

City:__________________ State: _______ Zip} ____________:

Phone No. ______________________________

Our Club Supports the Following Local Charities:

______________________________

_____________________________

Fund Raisers in Our Club include:

_____________________________


	If you would like more information about the “Emblem Club Name & number” Please write to us at the following address or E-mail us for more details.

Name: ______________________________

Address: ____________________________

City: _____________ State: _____ Zip:____

Phone No: __________________________

E-mail Address: _______________________

Music Optional:

1st Choice: __________________________

2nd Choice: ________________________


	Send completed form with check & picture to: Judy Lyon 2515 Mt. Vista Centralia, WA 98531 email: lyonjag@comcast.net