General Data Form	FCS-753 11-2016
Membership Data This form is to be completed annually and sent to the respective parties by August 1.
1. County Name
2. Total number of clubs in your county
3. Number of members in your county
4. Number of members at large in your county
5. Number of new clubs added since July 1 of the previous year
6. Number of new members enrolled since July 1 of the previous year
7. Total number of volunteer hours
Send one copy to the AEHC Treasurer by August 1. Carolyn Morris P. O. Box 275 Danville, AR 72833 Send one copy to the State Extension Office by August 1. Melody Curtis 2301 S. University Little Rock, AR 72204
The University of Arkansas System Division of Agriculture offers all its Extension and Research programs to all eligible persons regardless of race, color, sex, gender identity, sexual orientation, national origin, religion, age, disability, marital or veteran status, genetic information, or any other legally protected status, and is an Affirmative Action/Equal Opportunity Employer.