SAMTrack.v4 - D.I.M.E. Reporting Form

D.I.M.E. - SAMTrack.v4 Reporting Form
Before completing this form, please be aware that it is password protected. Please send an email to imperial.samdime@gmail.com to request the password
Password *

D.I.M.E. Court Report
Select Region*

Deep South Region IDeep South Region IIMid-Atlantic RegionMid-Western Region IMid-Western Region IINorth Eastern RegionWestern Region IWestern Region II
Select Desert & Court
Deep South Region I Deserts*
Deep South Region II Deserts*
Alabama Courts*
Arkansas Courts*
Florida Courts*
Georgia Courts*
Louisiana Courts*
South Carolina Courts*
Mississippi Courts*
Missouri Courts*
Oklahoma Courts*
Tennessee Courts*
Texas Courts*
Bahamas/ US Virgin Island Courts*
Mid-Atlantic Deserts*
Delaware Courts*
District of Columbia Courts*
Maryland Courts*
North Carolina Courts*
Virginia Courts*
West Virginia Courts*
Far East/ Japan Courts*
Mid-Western I Deserts*
Mid-Western II Deserts*
Illinois Courts*
Indiana Courts*
Iowa Courts*
Kansas Courts*
Kentucky Courts*
Michigan Courts*
Minnesota Courts*
Nebraska Courts*
Ohio Courts*
Wisconsin Courts*
North Eastern Deserts*
Connecticut Courts*
Massachusetts Courts*
New Jersey Courts*
New York/ Canada Courts*
Pennsylvania Courts*
Rhode Island Courts*
Western I Deserts*
Western II Deserts*
Alaska Courts*
Arizona Courts*
California Courts*
Colorado Courts*
Hawaii Courts*
Nevada Courts*
New Mexico Courts*
Oregon Courts*
Washington Courts *
Western Europe Courts *
Court Contact Information
D.I.M.E. Court Chairperson Name*

First NameLast Name
D.I.M.E. Court Chairperson Email Address*
example@example.com
D.I.M.E. Court Chairperson Phone Number*

Area CodePhone Number
Project/ Event Details
Start Date of Project/ Event*

MonthDayYear
Date
End Date of Project/ Event*

MonthDayYear
Date
No Activity to Report

If selected, please explain below
Explanation of no activity*

0/300
Participation
Names of Participating Mentors - Daughters ONLY *
DO NOT Enter Names of youth or Nobility
Total # of Participating Mentors:*
Total # of Participating Mentees*
Age Range of Mentees:*

7 - 10 yrs old11 - 13 yrs old14 -18 yrs old
Total # of Hours Spent with Mentees*
Total # of Hours (In-Kind Service) for Project/ Event
This field will auto-populate the ACTUAL In-Kind Service Hours
Was this a joint Court/ Temple project/ event?:*

N/AYesNo
Was this a collaborative project/ event with a non-masonic organization?:*

N/AYesNo
Name of non-Masonic Organization
Example: Girl Scouts, YWCA, elementary school, library, etc.
Brief description of project/ event*

0/300
What was the outcome of your mentoring efforts?:*

0/300
Educational Goals
Did your Court mentoring efforts assist is increasing the G.P.A. of your Mentee(s)?:*

N/AYesNo
How did the mentoring efforts support the Mentee(s) in increasing their G.P.A?:*

0/300
If "No" is selected: Please explain below*

0/300
Did your Court mentoring efforts assist in reducing the high school drop out rate?:*

N/AYesNo
How did the mentoring efforts encourage the Mentee(s) in reducing the drop out rate and reaching their educational goals?:*

0/300
If "No" is selected: Please explain below*

0/300
Feedback
How can the D.I.M.E. Mentoring Initiative assist your Court in your mentoring efforts?:*

0/300
Additional Contact Information
If your Desert does not have an assigned D.I.M.E. Desert Directress, please select this option:

No Desert Directress Assigned
DESERT - D.I.M.E. Directress

First NameLast Name
DESERT - D.I.M.E. Directress: Email Address
example@example.com
DESERT - D.I.M.E. Directress: Phone Number

Area CodePhone Number
Deputy for the Desert:*

First NameLast Name
Deputy for the Desert: E-mail Address*
example@example.com
Deputy for the Desert: Phone Number*

Area CodePhone Number
Please be sure to print a copy or forward your report via email to your Illustrious Commandress and the Deputy for the Oasis.
Should be Empty:

D.I.M.E. - SAMTrack.v4 Reporting Form

D.I.M.E. Court Report

Select Desert & Court

Court Contact Information

Project/ Event Details

Participation

Educational Goals

Feedback

Additional Contact Information