Date *

Submitted By *

Program Name *

Program Description *

Budget Total *

Program Presenter *

Weather ConditionsClearFoggyOvercastRainThunderstormSnow

Temperature *

Mostly In Attendance *Children (up to 12)Youth (13-19)Young Adults (20-35)Adults (36-59)Seniors (60+)

Number of Adults Attending *

Number of Children Attending *

Money Collected *

Interpreter’s Remarks *

0 + 8 = ?Please prove that you are human by solving the equation *