PROGRAM QUESTIONNAIRE / REPORT 2008

SOCIETY ________________________________________________________________________

PROGRAM CHAIRMAN ____________________________________________________________

Please return this completed form, including Program Report on reverse side to:

(Attach additional sheet of paper if necessary)                        
Cheri George
CFMS Program Aids
5006 N. Bentree Circle
Long Beach, CA 90807-1009





PROGRAM REPORT - 2008

SOCIETY___________________________________________________________________________________

PERSON REPORTING ________________________________________________________________

TITLE _____________________________________________________________________________

ADDRESS ________________________________________________________ PHONE __________

CITY, STATE, AND ZIP _______________________________________________________________



MONTH PROGRAM
                         (Include name and tilte, if any, of presenter, address and                         
phone number if possible, and description of program.)
NUMBER
ATTENDING
         HOW RECEIVED