Zone 4

Zone 4

Multiple District MD5M Newsletters

ZONE 4 CHAIR

Ervin Heisler (Susan)

5918 Halifax

Brooklyn Center, MN 55429

R: 763-535-6849

B: 763-323-5331

CLUBS

Champlin Corcoran

New Hope Robbinsdale

Golden Valley Courage Center

Please use this form to submit your monthly activities report.

When you have filled in all of the fields click the submit button to send your report.

If you had no activity to report please enter "NONE" in the text box

Club Name
Month and Year
Is this is a new or revised report?	New Revised
Adds	Please enter a number.
Drops	Please enter a number.
Current Total	Please enter a number.
List Completed Activities Please include the number of participating members and the total number of man hours worked.
List upcoming activities and dates.
List contributions with amounts.
This Form Completed By (Your Name)
E-Mail Address

Click here to submit your report. Click here to start over.