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To be completed by the Secretary and submitted to the HI-Y Leadership Center by the 7th of the following month.

HI-Y:      For the Month of:
School:      Date:
Secretary:      Advisor:
Secretary Home Address:      Phone:
City:      State:      Zip:
E-mail Address:
HI-Y ACTIVITIES THIS MONTH:
I. HI-Y Conference Attended this Month
Jr. HI-Y Fall Conf.    No. Involved:
Sr. HI-Y Fall Conf. Camp Willson    No. Involved:
Sr. HI-Y Fall Conf. Jackson's Mill    No. Involved:
Jr. UN Cedar Lakes    No. Involved:
Sr. UN Parkersburg    No. Involved:
OH Youth in Government    No. Involved:
WV Youth in Government    No. Involved:
Sr. or Jr. HI-Y Leadership Conf. at Horseshoe    No. Involved:
Other Conference:    No. Involved:
II. Meeting Program Topics
Date of Meeting:
Topic: Presenter:
III. School Service Projects
School Service Project:
Purpose:
No. Members who helped:    X    No. Hrs of Service:    =    Total Vol. Hours:
School Service Project:
Purpose:
No. Members who helped:    X    No. Hrs of Service:    =    Total Vol. Hours:
School Service Project:
Purpose:
No. Members who helped:    X    No. Hrs of Service:    =    Total Vol. Hours:
School Service Project:
Purpose:
No. Members who helped:    X    No. Hrs of Service:    =    Total Vol. Hours:
IV. Community Service Projects
Community Service Project:
Purpose:
No. Members who helped:    X    No. Hrs of Service:    =    Total Vol. Hours:
Community Service Project:
Purpose:
No. Members who helped:    X    No. Hrs of Service:    =    Total Vol. Hours:
Community Service Project:
Purpose:
No. Members who helped:    X    No. Hrs of Service:    =    Total Vol. Hours:
Community Service Project:
Purpose:
No. Members who helped:    X    No. Hrs of Service:    =    Total Vol. Hours:
V. Training Activities to help members carry out our purpose
Activity:      No. Involved:
Activity:      No. Involved:
VI. Fundraising Activities
Activity:      No. Involved:
Activity:      No. Involved:
VII. Social Activities
Activity:      No. Involved:
Activity:      No. Involved:
VIII. Publicity (Check those accomplished this month)
Radio or TV spot    Newspaper Articles
Bulletin Board         School Newspaper
Special Promotion (i.e. HI-Y Week)
Copies of Newspaper Articles, Programs, etc. are to be Mailed to the Leadership Center
IX. Extending HI-Y
A. HI-Y Extension - Provides funds each year to support HI-Y, Youth in Government, United Nations, Fall Conference and HI-Y Leadership Camp at Horseshoe.
Yes    No    Amount:
B. Project Horseshoe - Supplies/materials or a monetary gift given to the Camp.
Yes    No    Amount:    and/or Supplies:
C. Cave Lake - Supplies/materials or a monetary gift given.
Yes    No    Amount:    and/or Supplies:
D. Organized a new HI-Y - Officers' and Advisors' names must be sent to the HI-Y Leadership Center for follow-up.
Yes    No   
E. World Service - This gift is a special way of helping people around the world help themselves through the YMCA of the USA World Missions projects.
Yes    No    Amount:
HELP!
List ways the HI-Y staff may assist you. (Ideas, communication, fund raising, project possibilities, leadership training, etc.)

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Ohio-West Virginia State YMCA      HI-Y Leadership Center
P.O. Box 239    Pt. Pleasant, WV 25550
304.675.5899

The Ohio-West Virginia State YMCA, operating as the HI-Y Leadership Center is a 501(c)(3) not-for-profit organization.
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