EmailMeForm
Charitable Data Reporting Form 2018-19 (West)
All State Officers, Chairpersons, & District Chairpersons to fill out this form. Fields marked with an asterisk (*) are required fields.
Name
*
Date of Event
*
MM
/
DD
/
YY
Your Home Lodge
*
Select Your Home Lodge
Buckeye # 2686
Gila Bend #2089
Lake Havasu City #2399
Parker #1929
Phoenix #335
Phoenix West #2729
Raceway #2852
Scottsdale #2148
Sun City #2559
Wickenburg #2160
Yuma #476
Select your home Lodge from this dropdown menu.
Position(s)
AEMP Affiliation
District Chairperson
District Deputy
District Leader
Grand Lodge Committeeman
Laws & Resolution Committee
Past Presidents Association
Ritual Advisor
State Chairperson
State Officer
Veterans Affairs
Other
Other Position Not Listed
Please check what position(s) you hold in the Arizona Elks Association.
Email
Function
*
Please Select a Function
My Committee Work - General
AEA Progress/Organizational Meeting
Convention - National
Convention - State
Convention Mid Year - State
DD Clinic
Golf Tournament - Charitable
Hoop Shoot - Local
Hoop Shoot - District
Hoop Shoot - State
Hoop Shoot - National
Leading Knight Clinic
Official Visitation
Ritual - Competition
Ritual - Training/Testing
Scholarship
Soccer Shoot - Local
Soccer Shoot - District
Soccer Shoot - State
Other
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.
Number of Elks
Number of Helpers (Non Elks)
Total Hours Planning & Attending (Elk Member)
Total hours spent planning for, working, and attending meetings, functions, Lodge Visits, and other Elk functions of a charitable nature. Elk Members Only
Total Hours Planning & Attending (Non Elk Helpers)
Total hours spent planning for, working, and attending meetings, functions, Lodge Visits, and other Elk functions of a charitable nature. Non Elk Members only.
Elk Miles
Total mileage to & from meetings, functions, Lodge Visits, and other Elk functions of a charitable nature. Elk Members only.
Helper Miles
Total mileage to & from meetings, functions, Lodge Visits, and other Elk functions of a charitable nature. Non Elk Members only.
Total Contributions - Non Cash (Estimated Value)
Total of Elk and Non Elk Members contributions. This can be estimated to the best of your ability.
Monetary Contributions - Total of your "Out of Pocket" as well as your "Budgeted" funds
Misc Items
Any other items or remarks you think would pertain to Charitable Data.