IF THERE ARE ANY PROBLEMS WITH THIS FORM, PLEASE CONTACT JIM MASLACH AT 440-785-9838 OR VIA EMAIL AT kofcjkm@gmail.com.


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ONLY SUBMIT ONE REPORT PER DEGREE.

DO NOT REPORT MULTIPLE DEGREES ON A SINGLE FORM

DEGREE EXEMPLIFIED (CHECK ONLY ONE): *
LOCATION:

CANDIDATE DETAILS (EXEMPLIFICATION OF CHARITY, UNITY AND FRATERNITY ONLY)


Participating Councils - New Members Only

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 Council #New Mbrs
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 Council #New Mbrs
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450    04/14