Charitable Data Reporting Form

All State Officers, State Chairpersons, & District Chairpersons to use this form

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Convention 2012:

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Updated: October 26th, 2011

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Updated: October 6th, 2011

Charitable Data Reporting Form

All State Officers, State & District Chairpersons to fill out after a Charitable Event

Charitable Data Reporting Form
All State Officers, Chairpersons, & District Chairpersons to fill out this form. Fields marked with an asterisk (*) are required fields.

Last Name *

First Name *

Your Home Lodge *

Select your home Lodge from this dropdown menu.

Home Phone

###

####

Cell Phone

###

####

Email

Function *

Select a function from the dropdown menu. If function is not listed, please select "Other" at the bottom and fill in the next field with the function name.

Other Function

Enter Function Name if not listed in above dropdown menu.

Total Travel Mileage

Total mileage to & from meetings, functions, Lodge Visits, and other Elk functions of a charitable nature.

Total Travel Hours

Total hours spent traveling to & from meetings, functions, Lodge Visits, and other Elk functions of a charitable nature.

Total Hours Planning & Attending

Total hours spent planning for, working, and attending meetings, functions, Lodge Visits, and other Elk functions of a charitable nature.

Phone & Postage Charges

All Elk related long distance phone charges and postage for charitable purposes.

Income

Major project income and budget amounts not reported by individual Lodges.