State Council Service Program Awards Entry Form

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THIS REPORTING FORM MUST BE COMPLETED BY EACH Council AND FORWARDED TO THE State Council .(A separate reporting form should be completed for each Program category.)Page 1 of 2 continued on reverse Category (mark one): Faith Family Community liFeCOUNCIL INFORMATION: Council numBer: ___________________ total Council memBerS: __________grand knight: __________________________________ e-mail: ________________________________PROJECT INFORMATION /complete all sections0:ProjeCt title: ________________________________________ _ ProjeCt date: ____________________Participation:______ ____ + __________ = ____________ ____________ x ___________ = ______________ Members Non Members Total Participants Total Participants Hours Total Volunteer HoursProgram Planning:___________ & ___________ members recruited:_

this reporting form must be completed by each council and forwarded to the state council. (a separate reporting form should be completed for each program category.)

  Programs, Services, Council, Entry, Council service program