LRC Work Assessment Form  

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Text Box: Work Assessment Validation Form
 
___________________________
                                                                                                                                                           (Member Number)
 
                 Member                     _______________________________________________________________
                                                                                                      (Signature)
 
                 Member Address      _______________________________________________________________
 
                 Project                       _______________________________________________________________
 
                 Project Coordinator____________________________________________________/___________
                                                                                                      (Signature)                                           (Date)
 
                 After a project is completed, fill in this form, sign it and have the coordinator validate with his/her signature and date.  Return before your “Anniversary Date” for proper current year Work Assessment credit.  Bring to a monthly meeting and place in the box provided, near the membership table, or mail to the Club’s P.O. Box.  If this form is not retuned on time, credit will not be included in membership dues renewal calculations.
Text Box: Work Assessment Validation Form

___________________________
									  (Member Number)

	Member		_______________________________________________________________
						(Signature)

	Member Address	_______________________________________________________________

	Project		_______________________________________________________________

	Project Coordinator____________________________________________________/___________
						(Signature)			    (Date)

	After a project is completed, fill in this form, sign it and have the coordinator validate with his/her signature and date.  Return before your “Anniversary Date” for proper current year Work Assessment credit.  Bring to a monthly meeting and place in the box provided, near the membership table, or mail to the Club’s P.O. Box.  If this form is not retuned on time, credit will not be included in membership dues renewal calculations.