Lt. Governor's Kiwanis Visitation Form

Please complete this form within TWO DAYS of your club visit.

Lieutenant Governor * First Last
Division *
Lt. Governor's Email *
Kiwanis Club of *
Kiwanis Division *
Names of Sponsored Key Clubs *

Please use 1 line per club
If any other Key Club members were in attendance, please list their names, positions, and clubs:

Please put positions and clubs in parenthesis
List 1 name per line
Date of Visit * / MM / DD YYYY
Did you attend a... * Kiwanis Meeting Kiwanis Divisional Kiwanis Project
For Kiwanis Meeting/Divisional
Location
# of Visits to Date
For Kiwanis Project
Please describe the event/project:
Miscellaneous
Did you make a presentation of any kind? *
If yes, please describe
Do you think the Kiwanis Club is helpful and supportive of its Key Clubs?
Please explain: *
Was the Kiwanis Advisor present and involved? *
How often does the Kiwanis Club send members to its Key Club meetings? *
How often does the Key Club send members to its Kiwanis meetings? *
Other Comments
Kiwanis Club President / Kiwanis Division Lt. Governor * Yes