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Annual Survey of Fraternal Activity

For the twelve month period ending December 31, 2014

Due by: January 31

Important:

 
I. NUMBER OF MEETINGS HELD DURING YEAR:
1.    
2.    
3.    
TOTAL NUMBER OF MEETINGS HELD:    
II. ACTIVITY EXPENSE:
1. a. $
  b. $
  c. $
  d. $
  e. $
  f. $
TOTAL ACTIVITY EXPENSE: $
III. CHARITABLE DISBURSEMENTS:
Church Activities:
1. a. $
  b. $
  c. $
  d. $
  e. $
  f. $
  g. $
Total Church Disbursements: $
Community Activities:
2. a. $
  b. $
  c. $
  d. $
  e. $
  f. $
  g. $
  h. $
  i. $
  j. $
  k. $
Total Community Disbursements: $
Pro-Life Activities:
3. a. $
  b. $
  c. $
  d. $
  e. $
  f. $
  g. $
Total Pro-Life Disbursements: $
Youth Activities:
4. a. $
  b. $
  c. $
  d. $
  e. $
  f. $
  g. $
Total Youth Disbursements: $
TOTAL CHARITABLE (Church, Community, Pro-Life and Youth) DISBURSEMENTS:
    $
IV. FRATERNAL COMMITMENT:
Number of Visits to:
1. a.    
  b.    
Total Visits:    
2.    
3.    
Estimated hours of volunteer service:
4. a.    
  b.    
  c.    
  d.    
  e.    
Total Volunteer Hours:Total Volunteer Hours:    
Estimated hours of fraternal service:
5.    

Forwarding Instructions:
  1. Including your e-mail address allows you to receive a copy of your report via e-mail so that you can forward an electronic copy to any e-mail recipient at a later date.
  2. Enter the e-mail addresses you have available  (State Deputy and District Deputy).  Leave the line blank if you are unsure of the correct e-mail address.
  3. You will have the opportunity to print a copy of the form after you submit the form in the next step.
  4. Click the "Continue" button to confirm and submit your form.
 
     
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