Please submit new officers following election. List the current mailing address, telephone contact numbers (with area code), and email address(es) for each officer.

Click here to download a PDF version of this form. If you choose to complete the form using the PDF version, please mail a copy to Civitan International Headquarters. You may also email to IHQ at growth@civitan.org.

Report of Civitan Club Officers 2023-2024

Club Officers for 2023-24 (term beginning October 1, 2023)

  • This should NOT be a member's personal or home address.
  • This should NOT be a member's personal or home address.