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CHAPTER SERVICE REPORT
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Chapter Name, Number, City
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Number of Members (Including Pledges)
MILEAGE RATE
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Period Covered by this report:
APRIL, MAY JUNE _________
$0.____/MILE
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JULY, AUGUST, SEPTEMBER _____________
$0.____/MILE
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OCTOBER, NOVEMBER, DECEMBER _____________
$0.____/MILE
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JANUARY, FEBRUARY, MARCH ____________
$0.____/MILE
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SERVICEAB CD
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PROJECTSDESCRIPTIONHOURSMONIESDONATEDTOTAL
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GOODSDONATED
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MILES
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CHAPTER
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PROJECTS
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DISTRICT
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PROJECTS
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STATE
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PROJECTS
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ESA
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FOUNDATION
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IC
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PROJECTS
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OTHER PROJECTS
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TOTAL0000
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TOTALSAMOUNTS
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A.TOTAL HOURS#
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0
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B. TOTAL MONIES$
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0
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C. TOTAL DONATED $
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GOODS0
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D. TOTAL DONATED $
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MILESTOTAL MILEAGE X RATE OF$0.70(enter mileage rate)0
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TOTAL OF B C D 0
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Mail Original & 1 copy to:
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Chapter Service Chairman
District Coordinator
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NameName
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AddressAddress
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PhonePhone
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Email AddressEmail Address
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DUE DATE: 10TH OF THE MONTH FOLLOWING THE END OF THE QUARTER
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Updated 6/2025
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