Blue Pig - created by phpFormGenerator

Blue Pig

Blue Pig Report list the amounts and methods used to raise donations for Nevada SMP - Project Safe Haven.

Date of Report: * Please use the calendar provided to enter the date of the report.
Lodge: * Please select your Lodge.
Lodge Committee Chairperson: * Please enter the first and last name (in that order) of your Lodge's Chairperson.
Lodge Committee Chairperson E-mail Address: * Please enter your e-mail address. This is required for you to receive a copy of this report.

Blue Pig Donations: *

Please enter the amount of money received from Blue Pig Donations. $

Cash Donations: *

Please enter the amount of money received from cash Donations. $

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Please enter the name of other funtions held and the amount of money received. $

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Please enter the name of other funtions held and the amount of money received. $

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Please enter the name of other funtions held and the amount of money received. $

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Please enter the name of other funtions held and the amount of money received. $

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Please enter the name of other funtions held and the amount of money received. $

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Please enter the name of other funtions held and the amount of money received. $

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Please enter the name of other funtions held and the amount of money received. $

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Please enter the name of other funtions held and the amount of money received. $

Comments: * Please type in your comments - be specific. Tell us about any special activities your Lodge held to raise public awareness to your area of responsibility.

Type the following: For security purposes, please type the letters in the image.