2016 REPORT FORM
Part I
TOOTSIE ROLL PROGRAM FOR PEOPLE
WITH DEVELOPMENTAL DISABILITIES
Minnesota State Council
FROM ______________________________________ DIST.#_________________________
Knights of Columbus
(GRAND KNIGHT)
Mail to: Mike Schilling
COUNCIL NAME ____________________________ No. ____________________________
1062 Hillcrest Drive
City ____________________________________________________ Zip ________________
Woodbury, MN 55125
Date ___________________________________________________ 20 _________________
We have participated in the Tootsie Roll Developmental Disabilities Program. Our Council ordered _____________ cases. We distributed _____________ cases.
Council will be charged for cases not used for ID promotion. This will be a separate billing. Monies will not be deducted from the revenue collected. We suggest that you keep
the candy not dispensed. use the leftover candy for a project such as youth, community, or at a parade or store it in a cool, dry place and use first next year.
Total revenue collected
$ ____________________________
Number of volunteer hours____________________________
(Send entire amount collected in drive)
MAKE MONEY ORDER OR CASHIER'S CHECK PAYABLE TO: Minnesota Knights of Columbus
MAIL FORM ALONG WITH YOUR CHECK FOR THE FULL AMOUNT.
Parts I and II of this report must be completed, Parts III and IV should be left blank, and the entire form should be mailed with a
cashiers check for the FULL AMOUNT OF REVENUE COLLECTED by MAY 10th. THIS IS IMPORTANT!
Questions? Contact Chairman Michael Schilling at (651) 334-3822 or
(Retain gold sheet for council records.)
Part II
Part IV
Our Council plans to donate its share of the revenue to: (indicate name and percentage each is to receive)
For office only–Do not fill out
List name & number exactly as it appears on approved recipient list.
%
AMOUNT
CHECK NO.
Recipient
Recipient Name:
Number
State Council Fall Bowling for Special Olympics
5260
(Suggested 15%)
1.
%
2.
%
3.
%
4.
%
5.
%
6.
%
7.
%
8.
Part III
For Office Only –
Date ______________________________________
Leave This Area Blank
.
,
Total Revenue Received ................................$
cases
of candy retained
.
,
Minus Miscellaneous Expenses ......................$
$
.
,
Minus Cost of Tootsie Rolls .............................$
Amount Council owes
.
,
for retained candy.
Balance Remaining ........................................$