* 1. Please provide your name, your club's name and location (city & State)

* 2. Approximate current membership

* 3. Approximate current active membership (participates regularly in club functions, or management).

* 4. Regarding leadership which of these describes your club

* 5. Over the last ten years or so would you say membership has (answer all applicable):

* 6. Regarding dues, please check all applicable items if you have more than one membership level or class

* 7. General information - check all applicable items

* 8. Is there something your club does that might be profitably shared with other club leaders? If so briefly describe.

* 9. Please note where you think your club most needs to improve and might benefit from other's experience.

* 10. Regarding the potential for one or more leaders or potential leaders from your club to participate in a club management workshop at this year's MSRAL conference in Little Rock, please select the most appropriate answer.

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