Date Prepared: ____________________________ For Year: ___________________________
Pup Tent Name: ____________________________ Number: ____________________________
State: _____________________________________ City: ________________________________
|
Cootie Name |
Cootie No. |
|
Verified By |
| ____________________ | ____________________ | ____________________ | ____________________ |
| ____________________ |
Signature of Post Membership Chairman |
||
| ____________________ | |||
| ____________________ | |||
| ____________________ | |||
| ____________________ | ____________________ | ____________________ | ____________________ |
| ____________________ |
Signature of Post Membership Chairman |
||
| ____________________ | |||
| ____________________ | |||
| ____________________ | |||
| ____________________ | ____________________ | ____________________ | ____________________ |
| ____________________ |
Signature of Post Membership Chairman |
||
| ____________________ | |||
| ____________________ | |||
| ____________________ | |||
| ____________________ | ____________________ | ____________________ | ____________________ |
| ____________________ |
Signature of Post Membership Chairman |
||
| ____________________ | |||
| ____________________ | |||
| ____________________ |
This report copy to: Please check one: Supreme [ ] Grand [ ] Pup Tent [ ]