REPORTING FOR MONTH OF:           

FULL NAME:                                         

VOLUNTEER ACTIVITIES SINCE LAST REPORT:  (include date/time spent)

PROBLEMS ENCOUNTERED OR SUCCESSES ATTAINED IN YOUR VOLUNTEER WORK:

 TOTAL Volunteer Hours  (enter as number such as 3 or 3.5)  
 

Total Number of People Contacted  

Minority Contacts:  (enter as a number such as 2)

 Black                 
Hispanic              
Asian                   
Native American  
Other                   

Today's Date

      (by Pressing SUBMIT, your report will be automatically e-mailed to Cooperative Extension)