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Lioness Conversion Program Form

LIONESS CONVERSION PROGRAM

Effective January 1, 1996 the Lions Clubs International Board of Directors approved a Lioness Conversion Program granting Lions, who were former Lionesses, their past Lioness years of service when they become Lions.

LIONESS CONVERSION HISTORICAL RECORD

*First Name:
Middle Name:
*Last Name:
Maiden Name:
*Address:
*City:
*State:
*Postal Code:
*Country:
*Current Lions club name:
*District #:
*Club #:
*Member # in club:

*Original Lioness Join Date:	Month:	Year:
*Original Join Date in a Lions Club:	Month:	Year:

*Years of Service to be credited to my Lions record:

For Internal
Use Only

Gender:

Each Lioness requesting their service credit be transferred to a Lions club is asked to complete this form either online or to print out a copy and mail or fax it in. A separate paper version of this form is also on the LCI Web site.

Clubs submitting this form online should also submit a WMMR. Clubs submitting the paper version of this form should attach the appropriate MMR before mailing.

Questions relating to this policy should be addressed to:

Lions Clubs International
Extension & Membership Division
300 W. 22nd Street
Oak Brook, IL 60523-8842, USA
Fax: 630-571-1691

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