Print Form
Return to the 4-H Office by December 31st
With attached club program calendar for the new year
CLUB INFORMATION SHEET
This information is for the new 4-H year:
Club Name_______________________________________Club Number __________
Meeting Date________________________________Time________ Precinct________
What months club does not meet ___________________________________________
Where club most often meets ______________________________________________
Address_______________________________________________________________
______________________________________________________________________
Club Officers: President__________________________________________________
Vice President _____________________________________________
Recording Secretary_________________________________________
Corresponding Secretary______________________________________
Treasurer__________________________________________________
Reporter___________________________________________________
Song Leader _______________________________________________
Sunshine Person ____________________________________________
Recreation Leader___________________________________________
Historian__________________________________________________
Other_____________________________________________________
Club’s Major Project Interests
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Club Name __________________________
CLUB FINANCIAL INFORMATION
If your club does not have any bank accounts, please check here:
______________
Club tax (IRS) exempt number ___________
Club sales tax exempt number __________
Checking Account Information
Certificate of Deposit Information
Where ______________________________
Where _____________________________
Account Number ______________________
Account Number _____________________
Balance _____________ as of __________
Date
Balance________________as of _________
Date
Savings Account Information
Shoebox Account
Where _______________________________
Who keeps funds _____________________
Account Number _______________________
Where ______________________________
Balance _______________ as of __________
Date
Balance______________ as of __________
Date
(A shoebox account is similar to petty cash. You may
not keep more than $100.00. All income & receipts
should be recorded in the Treasurer’s book.)
_______________________________________________________________________________________________
Signature of person providing this information. I verify that the above information is a correct accounting of monies and is recorded in
a treasurer’s book and reported monthly to club or unit members.
If you have more than one account or belong to more than one banking institution, please let the 4-H Office
know. Annual Financial Summary Forms are due February 15th of each year.
CLUB BYLAWS
The above named club (does______) have bylaws.
Enclosed is a copy of the club bylaws with the nondiscrimination statement included.
Leader Signature:
Date:__________________
University of Maryland Extension programs are open to all citizens without regard to race, color, sexual
orientation, gender, handicap, religion, age, marital or parental status, or national origin.
NF 2010