Charity Report

* CHARITY REPORT *

STATE CHAIR
BONNIE HOWELL

(BRUCE)
NE District - Milford, DE Lodge #2401
Cell : (302) 632 - 0420 / Email: bhowell48@verizon.net

** CHARITY REPORTING INSTRUCTIONS :

*** COMPLETE THIS FORM AND CLICK ON SUBMIT AND YOUR CHARITY DATA REPORT WILL BE SENT TO STATE GOVERNMENT RELATIONS CHAIR's EMAIL FOR AUTOMATIC REPORTING FROM YOUR LODGE.
** ALL FIELDS WITH AN ASTERISK ( * ) MUST BE COMPLETED.
* IF ANY BOX HAS NO VALUE OR NUMBERS - THEN PLACE A "0" IN THAT BOX PROVIDED.

~ CHARITY REPORT FORM:

* Indicates required field

NAME of LODGE & NO. *

DISTRICT *

NAME of PERSON SUBMITTING FORM *

First

Last

TITLE AT LODGE *

EMAIL *

PHONE / CELL *

SELECT MONTH REPORTING *

COMMITTEE REPORTING *

DATE of EVENT *

CHARITY EVENT / ACTIVITY *

B. No. of People *

C. Elks *

D. Non-Elks *

E. Elk Hours *

F. Non-Elk Hours *

G. ELK MILES *

H. Non-ELK MILES *

I. Non-CASH *

J. CASH VALUE *

ADDITIONAL COMMENTS *

SUBMIT to GOV'T RELATIONS

~ Charitable Committees:
   ...Antlers / Americanism / Drug Awareness / Elks Camp Barrett / Hoop Shoot / ENF / Veterans/Military / Scholarship / Soccer / Youth Activities ~ and/or ~ Activities: Youth Tennis, Golf & Bowling, Scouting, Community Service, Community Recognition, Blood Banks, Food Baskets, etc.
~ Columns C & D:
   ...Count individuals traveling with you - not teams or groups
~ Columns E & F:
   ...Indicate total hours - Example: if [2] elks (or non elks) worked [6] hours (2x6) = 12 hours
~ Columns G & H:
   ...Round-trip miles traveled to attend event x # of people in car: Example: 4 people in car x 60 mile round-trip = 240 miles
~ Column I:
   ...Cash value of contributions: Food, clothing, gifts, etc.
~ Column J:
   ...cash used for Event.

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*** CHARITY REPORT ***

** CHARITY REPORTING INSTRUCTIONS :

~ CHARITY REPORT FORM:

* CHARITY REPORT *