Please do not click the submit button until finished
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.
Did your Auxiliary send a donation for the Junior Unit Program to the Department?
Amount Check Number Date:
Did your Auxiliary send a donation to a specific Junior Unit?
Unit #
If you have a Unit, explain the overall assistance the Unit gave the Auxiliary this year and in which programs the assistance was given.