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Tippecanoe Co. Extension Homemaker
Achievement Event Program Information
Club Presidents: Please complete the following form by March 1st to be included in the
Achievement Event Program
2023 Achievement Event: Nina Morgan-Chair
Mary Hancock –Co-Chair

Return by March 1st to:
Nancella Dobbins
TCEH Treasurer
3033 Greenbrier Avenue
West Lafayette, IN 47906
dobbinsnj@comcast.net

CLUB: _______________________________________________________________

NEW MEMBERS— List any new members that have joined your club this past year and the date they joined.
Name ______________________________________________________ Date __________________
Name ______________________________________________________ Date __________________
Name ______________________________________________________ Date __________________
Name ______________________________________________________ Date __________________
Name ______________________________________________________ Date __________________
Name ______________________________________________________ Date __________________

DECEASED MEMBERS—List any members who died this past year and the date.
Name _____________________________________________________ DOD ___________________
Name _____________________________________________________ DOD ___________________
Name _____________________________________________________ DOD ___________________
Name _____________________________________________________ DOD ___________________

Revised Aug 2022 nm