Community Hospital and Nursing Home On Line Report   

Please do not click the submit button until finished


Please report your Community Hospital and Nursing Home  projects below.

Date of this report  - mm/dd/yy               

Auxiliary Number              District Number            

Enter Name of person completing online report      

Enter Auxiliary Chairman's name              

                    street address         

                  city state and zip        

                      Phone                     999-999-9999

    Email:                  

    You must enter an email address where you can be reached.  If the chairman doesn't have an email address, enter the email

    of the person completing the report.

Please do not enter dollar signs or commas in numeric amounts.


 

 

 

Number of Volunteers

Hours   

Amount/Value

Auxiliary members volunteering in Community Nursing Homes and  Hospitals or facilities where we have no VAVS Representatives

             

 

             

               

    N/A

Auxiliary Members making donated items for Community Nursing Homes and Hospitals or facilities where we have no VAVS Representatives

 

            

                

 

$

Auxiliary sponsored non-member volunteers in Community Nursing  Homes and Hospitals or facilities where we have no VAVS Representatives

 

             

             

 

N/A

Auxiliary sponsored non-members making donated items for Community Nursing Homes and Hospitals or Facilities where we have no VAVS Representatives

 

 

             

Did your Auxiliary or Auxiliary members participate in the Hospitalized Veteran Writing Project?

 

N/A

 Describe your Auxiliary’s Outstanding Hospital Project:  (use extra paper if necessary)

                                                              

Any other information you want the Department Chairman to know:

                                                               

 

 

 


Copyright © 2007 Ladies Auxiliary VFW Department of Illinois. All rights reserved.
Revised: 06/13/08