State regent

Campus Court Officers

for the 20____ to 20____ school year. Date of election: ______________ _____, 20_______

Court __________________________________________________________________ #_________

College/University ________________________________City __________________ State_____

The Financial Secretary should complete this form immediately following the election held at the first meeting of the Fall semester. Even if you do not have any changes in officers or have been recently instituted, this form must be completed every year. Your prompt attention to this request will be appreciated. Please PRINT neatly.

Please submit ORIGINAL form to:

Catholic Daughters of the America

10 West 71^st Street, New York, NY 10023

Send one copy to your State Regent

Send one copy to the

National Chairman for Campus Court

Regent: Name ______________________________________________________________________ □ new □ re-elected

Address _____________________________________ City __________________________ State ______ Zip ____________

E-Mail ___________________________________ Phone# (________)______________ Cell# (________)______________

Vice Regent: Name _________________________________________________________________ □ new □ re-elected

Address _____________________________________ City __________________________ State ______ Zip ____________

E-Mail ___________________________________ Phone# (________)______________ Cell# (________)______________

Recording Secretary: Name _________________________________________________________ □ new □ re-elected

Address _____________________________________ City __________________________ State ______ Zip ____________

E-Mail ___________________________________ Phone# (________)_______________ Cell# (________)______________

Financial Secretary: Name ___________________________________________________________ □ new □ re-elected

Address _____________________________________ City __________________________ State ______ Zip ____________

E-Mail ___________________________________ Phone# (________)_______________ Cell# (________)______________

Treasurer: Name ____________________________________________________________________ □ new □ re-elected

Address _____________________________________ City __________________________ State ______ Zip ____________

E-Mail ___________________________________ Phone# (________)_______________ Cell# (________)______________

Chaplain/Spiritual Advisor: Name _______________________________________________________ □ new □ returning

Address _____________________________________ City __________________________ State ______ Zip ____________

E-Mail ___________________________________ Phone# (________)______________ Cell# (________)______________

Campus Court Advisor: Name _______________________________________________________ □ new □ returning

Address _____________________________________ City __________________________ State ______ Zip ____________

E-Mail ___________________________________ Phone# (________)______________ Cell# (________)______________