Community Service Program Report Form
January 1, 2010 to December 31, 2010 ♦ January 1, 2011 to December 31, 2011
(It is the club’s responsibility to copy this form and use it for both years.)
(This report may be shared with other GaFWC clubs.)
Name of Program: Collaboration
Part I. Tell us about your club
Name of Club _________________________________________________________________________________
District # ______________ Circle One: General Junior Juniorette
Number of Members _____________
Part II. Tell us about the person who prepared this Report
City ______________________________________________ Zip Code ____________________________
Phone _________________________________ E-Mail ____________________________________________
Part III. Tell Us What You Did
Activities listed in GFWC/GaFWC programs/projects should be reported in the appropriate program/project area on
the reverse side
Activities not listed in GFWC/GaFWC program materials should be reported in the program/project area which most
closely relates to your project.
Narratives are optional but enhance the options for judging
If you choose to submit a narrative description of your project/activities, please check the “narrative enclosed” box
and then attach the narrative to this Report Form.
Narratives may not exceed two (2) single-spaced typed pages in no less than 10 point type.
Copy your report for your own club and then forward a copy to each of the following: (General & Junior Clubs)
Mary Ruth Kimsey, Collaboration Chairman Peggy Wilson
P.O. Box 429 657 Harbour Shores Dr.
Union City 30291 Jackson, GA 30233
General Federation of Women’s Clubs
1734 N Street, NW
Washington, DC 20036
Junior Clubs should also send a copy to: Kathryn Youles, Director of Junior Clubs
117 Hobby Ave.
Sandy Ahearn, GaFWC Director of Junior Clubs Special
330 Malabar Way
Athens, GA 30605
Collaboration Program # of Members Volunteer In Kind Dollars
(List Projects Your Club Did) Participating Hours Donations Donated
limit to 3 pages (you may copy this page twice)
please do not change spacing-15 blocks per page
**Total number of members cannot be more than the total number of members in your club.
Narrative Enclosed □ Yes □