LOST MEMBERS REPORT FORM

SUP Chapter Name

Member Name

First Name

Last Name

Member's Last Known Address

Any Details of Member's Possible New Residence

Member's Birthdate

Name of Member's Spouse

Name and Position in the Chapter of Individual Submitting this Form

Due Dilligence

Which of the Following Steps has the Chapter Fulfilled

Attempted Contact by Phone

Attempted Contact by Email

Searched for Online Obituary

Attempted Contact at Known Address

Attempted Knwledge of Whereabouts of Friends, Neighbors and Family

Discussed Member in Recent Chapter Board Meetings

Discussed with Chapter's Assigned AVP

Life Member

Does this member have a subscription or gift subscription to PIONEER magazine?

Yes

Additional Notes and Information if Needed

The National Society of the Sons of Utah Pioneers