STATE DIRECTORY FORM

Council Number -   Council Name–

Do you meet at your church? YES  NO

If no, then where?

Council Email

Council Fax

Main Business meeting day and time–

Other business/social meeting day and time–

Nickname                            

Wife’s Name                          

Mail Address         

City,Zip           

Home Phone                 

Work Phone                

E mail 

Fax                     

Full Name

Nickname

Wife’s Name

Mail Address

City, Zip

Home Phone

Work Phone 

E mail

Fax    

Title, Full Name, Order                                                   

Street/Address         

City/Zip        

Home Phone                

Office Phone                 

Email                       

Name

Street/Address

City/Zip  

Phone

Fax 

EMail