LPA Event Summary Report
This form should be completed at the completion of each chapter event or District Regional and will be compiled into an quarterly & annual report for each District.

NOTE: For “type of event”, give a brief overview of event, like – pool party, trip to zoo, Santa Village visit, general monthly meeting, etc. For anything special that took place, give a brief description of the event, and highlight anything special that was offered or anything of interest that took place.
Report Completed By: *
Chapter (if Regional - list Chapter where Regional was held) *
District *
Date of Event
MM
/
DD
/
YYYY
Type of Event
Attendance (can be estimated) *
Were there any MAB in attendance? (MAB represents any medical professionals on LPA's Medical Advisory Board)
Clear selection
If yes, briefly explain how the MAB were involved.
Please list any LPA Officers in Attendance
Briefly describe the event (1-2 sentences only). And include anything special that took place during this event.
Submit
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