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Modified Form 10784 Report of Program Participation
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Name and Date of the Program
Family Prayer Knight
Bi Monthly Rosary
Lecturer Series
Morning Rosary
Into the Breach
Silver Rose
St. John Icon Prayer Service
Other:
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Council #
Your answer
Date
MM
/
DD
/
YYYY
# of Persons Participating?
Your answer
Total Volunteer Hours for EVERYONE?
Your answer
Submitted by (Name) & Email
Your answer
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