FORM 10 NAME CHANGE BY MARRIAGE OR OTHERWISE FORM 6 DEATHS Arrange alphabetically Surname First – If Past Matron, Past ron, Dual Member, so state in center column Former Name NAME IN FULL, LAST NAME FIRST PM PP DM Date of Death Present Name Former Name 1 Present Name 2 FORM 11 MEMBERS LOST OR FOUND NAME IN FULL, LAST NAME FIRST Date Lost or Found 3 FORM 7 DEMITTED 1 If Past Matron, Past ron, Dual Member, so state in center column NAME IN FULL, LAST NAME FIRST PM PP DM Date of Demit 2 1 3 2 FORM 12 MEMBERSHIP RECAPITULATION FOR MONTH 3 MEMBERS beginning of month, from last return GAIN: By Initiation FORM 8 DROPPED FROM ROLL FOR N.P.D. By Affiliation If Past Matron, Past ron, Dual Member, so state in center column By Affiliation for Dual Membership NAME IN FULL, LAST NAME FIRST PM PP DM Date of Drop By Reinstatement By Other Causes 1 Total Gain for month Total membership including gain 2 LOSS: By Death By Demit 3 By Expulsion By Suspension By Dropped for N.P.D. 4 By Other Causes Total loss for month 5 MEMBERS end of month 6 FORM 13 7 I hereby certify that the foregoing return is correct and a true statement of the membership changes of this Chapter for this month. FORM 9 EXPELLED/SUSPENDED NAME IN FULL, LAST NAME FIRST Date Cause 1 Dated , 20 2 Chapter Seal
FORM 6 DEATHS If Past Matron, Past ron, Dual Member, so state in center column NAME IN FULL, LAST NAME FIRST PM PP DM Date of Death 1 2 3 FORM 7 DEMITTED If Past Matron, Past ron, Dual Member, so state in center column NAME IN FULL, LAST NAME FIRST PM PP DM Date of Demit 1 2 3 FORM 8 DROPPED FROM ROLL FOR N.P.D. If Past Matron, Past ron, Dual Member, so state in center column NAME IN FULL, LAST NAME FIRST PM PP DM Date of Drop 1 2 3 4 5 6 7 FORM 9 EXPELLED/SUSPENDED NAME IN FULL, LAST NAME FIRST Date Cause 1 2 FORM 10 NAME CHANGE BY MARRIAGE OR OTHERWISE Arrange alphabetically – Surname First Former Name Present Name Former Name Present Name FORM 11 MEMBERS LOST OR FOUND NAME IN FULL, LAST NAME FIRST Date Lost or Found 1 2 3 FORM 12 MEMBERSHIP RECAPITULATION FOR MONTH MEMBERS beginning of month, from last return GAIN: By Initiation By Affiliation By Affiliation for Dual Membership By Reinstatement By Other Causes Total Gain for month Total membership including gain LOSS: By Death By Demit By Expulsion By Suspension By Dropped for N.P.D. By Other Causes Total loss for month MEMBERS end of month FORM 13 I hereby certify that the foregoing return is correct and a true statement of the membership changes of this Chapter for this month. Dated , 20 Chapter Seal
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