2024 Compliance Submission

Before completing the 2024 Club Compliance Submission, please review the Licensing Agreement and Protecting Vulnerable Communities Handbook, linked below. You will be asked to accept both on behalf of your club.

Civitan International Licensing Agreement

Protecting Vulnerable Communities Handbook

Name(Required)

First Last

Email(Required)

Civitan Club Name(Required)

Current Office Held in this Civitan Club:(Required)

City(Required)

State(Required)

INTERNAL REVENUE SERVICE

Please enter your Civitan Club's current EIN number with the IRS:(Required)

Have there been any changes to your club's EIN or the club's status with the IRS?(Required)

Yes

If yes, please describe:

Has your club filed its most recent 990 with the IRS?(Required)

Yes

If no, please explain:

GOVERNANCE

Has your Civitan Club adopted any changes to the club's incorporation with the state or its governance documents (bylaws/policies)?(Required)

Yes

If yes, please upload the most recent document here:

Drop files here or

Max. file size: 32 MB.

OTHER ENTITY ASSOCIATED WITH YOUR CIVITAN CLUB

Does your club have a foundation or separate entity associated with it?(Required)

Yes

If yes, please provide complete details including name, EIN and contact information for at least one leader of that entity:

ADDITIONAL INSURANCE

Besides the Civitan International insurance policy covering clubs, has your club secured any of the following ADDITIONAL INSURANCE for the current year?(Required)

No additional insurance for current year

Directors & Officers Insurance

Special Event Coverage

Property Insurance

Fiduciary Liability Insurance

Automobile Insurance

Treasurer Surety Bond

Other

VULNERABLE COMMUNITIES PROTECTION

Have your club leaders recently reviewed Civitan International's Protecting Vulnerable Communities Guidebook, and do you accept its terms on behalf of your club?(Required)

(Link to download and review at the top of this page.)

Yes

To the best of your knowledge, have all your club members who are required to secure a current background check done so?(Required)

Yes

LICENSING AGREEMENT

The Civitan brand is trademarked and the property of the organization. To protect the organization and its brand, Civitan International requires a formal agreement by any entity using the Civitan brand. Have you reviewed this agreement and do you accept on behalf of your Civitan club?(Required)

(Link to download and review at top of this page.)

Yes