Your full name:
Your email address:
Your SCA name:

Membership Number:
Expiry (MM/DD/YY):

Branch:

Copies of this report to be send to (enter email addresses):
  Branch seneschal:
  Baron and/or Baroness (if applicable):
  Other:
A copy will be sent to your own address as well.

Deputies and Areas of Responsibility

Number of people Contacted:
By phone:
By Event Walk-By:
People who came with a friend:
Other:

What is your group doing/working on in the realm of recruitment, general Chatelaine activity, demos, etc.:

Deputy Reports (Gold Key, Demo Coordinator, Pied Piper):

Do you have any questions/concerns/problems about your office?

Any change in the contact info since last report?
Yes
No
If Yes, Please Specify:

Phone number: