2023 Club Activity Report

Please enter your information below.

Your Name *

First

Last

Please enter your given name, as it would appear on your insurance card. IE Johnathan vs. John





Report Your Activity: This can include any of the following: Club Meetings, Club Activities, Individual activities - time spent doing club-related activity independently or with others, Social gatherings or informal meetings with other club members *

Enter the Number of times you participated in your Clubs Activity Enter the Number of times you participated in your Clubs Activity (In Person) Enter the Number of times you participated in your Clubs Activity (Virtual)