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


 +

Only submit one report per Degree.
DO NOT report multiple Degrees on a single form.

Exemplification: *
Location:

Candidate Details (for Exemplification of Charity, Unity and Fraternity only)


Participating Councils - New Members Only

 Council #New Mbrs
1
2
3
 Council #New Mbrs
4
5
6
 Council #New Mbrs
7
8
9
 Council #New Mbrs
10
11
12


450    04/14