EmailMe Form - Americanism Report

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Reporting Month *
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Name
First Last
Americanism Chair
G/L Programs Participated In:
Lodge Brochure
Lodge Brochure (Y/N)
Americanism Essay Contest
Americanism Essay Contest (Y/N)
Heritage Corner
Heritage Corner (Y/N)
Children's Guide: Pledge of Allegiance
Children's Guide: Pledge of Allegiance (Y/N)
Classroom Flag Presentation
Classroom Flag Presentation (Y/N)
I Fly the Flag Recognition
I Fly the Flag Recognition (Y/N)
Show Your Colors America
Show Your Colors America (Y/N)
Flag History Display
Flag History Display (Y/N)
National Patriotism Week
National Patriotism Week (Y/N)
Fly the Flag Calendar
Fly the Flag Calendar (Y/N)
Get Out The Vote Programs
Get Out The Vote Programs (Y/N)
Flag Day/Veterans Day Programs
Flag Day/Veterans Day Programs (Y/N)
Distribution of Americanism Booklets
Distribution of Americanism Booklets (Y/N)
Other
Other
Articles
State Bulletin
Total Number of Articles In State Bulletin
Elks Magazine
Total Number of Articles in Elks Magazine
Lodge Bulletin
Total Number of Articles in Lodge Bulletin
Other
Total Number of Other Articles
Programs Conducted At:
Lodge Meetings
Total Number of Programs At Lodge Meetings
Community Events
Total Number of Programs At Community Events
Other Events
Total Number of Other Programs Conducted
Statement on Americanism in your Lodge:
Please Submit By The Due Date Of March 15, 2019
Exalted Ruler *
First Last
Exalted Ruler
Americanism Chair *
First Last
Americanism Chair
Date Time
MM / DD / YYYY
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Home Phone
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Home Phone Number
Mobile Number
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Cell Phone Number
Email *
Email we can contact you at
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G/L Programs Participated In:

Articles

Programs Conducted At:

Please Submit By The Due Date Of March 15, 2019