SHRINERS AS MENTORS REPORTING FORM
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Harram Temple No. 23
Monthly SAMS Report
Reporting Month
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Noble Name
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Email
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Enter names of participating Mentors – Nobles ONLY
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SUMMARY OF ACTIVITIESÂ
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Total # of Participating Mentors
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Total # of Participating Mentees
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PLEASE SELECT AGE RANGE OF MENTEES (SELECT ALL THAT APPLY):
7-10 YEARS OLD
11-13 YEARS OLD
14-18 YEARS OLD
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TOTAL HOURS FOR THE MONTH
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