Drug Awareness - created by phpFormGenerator

Drug Awareness

Drug Awareness "Volunteer Hours, Mileage and Literature Distributed Report".

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 the e-mail address where you would like your copy of this report sent. This can be your Lodges or your personal email address.

Number of Activities: *

Please enter the number of activities held by your Lodge.

Number of Elks: *

Please enter the number of Elks envolved with the event.

Number of Elk Hours: *

Please enter the number hours volunteered by Elks.

Number of Elk Miles Traveled: *

Please enter the total mile traveled by Elks.

Number of People Reached: *

Please enter the number of people reached by the events. This should not include the Elks and Non-Elks entered above.

Times Drug Awareness Trailer Used: *

Please enter the number of times the drug awareness trailer was used.)

Number of Successful Activities: *

Please enter the number of successful activities held by your Lodge.

Number of Non-Elks: *

Please enter the number of Non-Elks envolved with the event.

Number of Non-Elk Hours: *

Please enter the number hours volunteered by Non-Elks.

Number of Non-Elk Miles Traveled: *

Please enter the total mile traveled by Non-Elks.

Quantity of Materials Distributed: *

Please enter the number of pieces of material distributed. Please note types of items and literature and to whom distributed in the comment box.

Number of Times Elroy Used: *

Please enter the number of times you used Elroy the Drug Free Elks.

Public Relations: *

Please enter the number of times you were in the media (Radio, TV, News Paper, etc.).

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.
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