KANSAS CATTLEWOMEN ACTIVITY REPORT FORM 

Return to: KCW, 6031 SW 37^th Street, Topeka, KS 66614    Fax:  (785) 273-3399

Committee:  (Check all that apply)

		Beef Education		Beef Promotion

Beef Publicity	Event___________

                                  The following person(s) were involved:

Check One:

		In Store Demo Booth		Lecture/Speech		Radio/TV		Other

		News Article		School Presentation		Ranch Tour

 Number of People Reached:______________             Number of Presentations: ______________

Number of Volunteer Hours: ______________            Circulation Figure: ___________________

Date of activity/presentation______________ 

Summary of Event:

Submitted By:

Name:________________________________________________________________________

Address:______________________________________________________________________

                           Street  Address                              City                             State                                 Zip

Phone:_______________________________            Fax: _______________________________

E-mail:_______________________________

Please use this revised form to report all activities.  Send one form per presentation/activity!