eForms

:: Leader Change Form

This form is used to report Leader information changes to your Area.
The Area Secretary will make these changes at the LLLI organizational database.

Your CURRENT email:
(A copy of this information will
be sent to this email address)

Effective Date of Change:

Your District Advisor (DA):
(Your DA will be emailed a
copy of this information)

What information are you changing?
	Name Address Phone Fax email Group Leader Status

Please fill in ALL blank spaces in both the OLD and NEW INFORMATION.

NEW INFORMATION		OLD INFORMATION
Name		Name
Address		Address
City		City
County		County
State		State
Zip		Zip
Phone		Phone
Fax		Fax
Email		Email

Group:		Group:
Status:		Status:


Comments

	This report will be emailed automatically to Ellen Simpson (Area Secretary) and your District Advisor when you click "SUBMIT" on the preview page. Click on "PREVIEW REPORT" to continue to the next page.
			Need to start over?

After you click on "SUBMIT" at the bottom of the NEXT page, you should receive an automated email reply with a summary of the above information.

Click for Web site contact information. Feedback welcome. Last modified 07/03/2008.
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07/03/2008