TOOTSIE ROLL PROGRAM CHAIRMAN REGISTRATION

COLUMBUS CHARITIES - TOOTSIE ROLL PROGRAM

Council Chairman REGISTRATION Form
Helping People with Disabilities

Worthy Grand Knight,

The annual fund raising to Help People with Disabilities requires your confirmation that your Council will participate in this year’s drive and to provide contact information for your Council Chairman for our files.
Council Name*
Council Number*
District Number*
YesNo
Chairman Name

First NameLast Name
ERROR!

This form is for use by KOFC Councils in Washington State only!
Chairman Mailing Address

Mailing Address 1

Mailing Address 2

CityState

Zip Code
Grand Knight's Name*

First NameLast NameSuffix
Grand Knight's Email*
example@example.com
Submitted Date*

MonthDayYear
Date
Grand Knight's Signature*

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COLUMBUS CHARITIES - TOOTSIE ROLL PROGRAM