88
Forms
Membership Roster
Club Name:
Club Number:
Keep roster updated at the International
Ofce regularly to avoid mail delays.
Check One:
o Annual Roster:
Please delete all Members not shown on this
updated list.
o Roster Additions
o Roster Deletions:
Return to:
Optimist International
Junior Optimist Department
4494 Lindell Boulevard
Saint Louis, MO 63108
Fax: (314) 371-6006
youthclubs@optimist.org
Name Date of BirthSex
FORMS