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


DEGREE EXEMPLIFICATION REPORT

 +

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)


Please list the council and the number of candidates below.
 Council ## Candidates
1
2
3
4
5
Please list the council and the number of candidates below.
 Council ## Candidates
6
7
8
9
10

450    04/14