Report Relay For Life Event

Date of Event

Chapter

College

Campus

City

State

Chapter Contact Name

Phone

City Location

State Location

Is this a new Relay For Life event that your chapter was instrumental in starting?

Does your chapter host or serve as the planning committee for your local Relay For Life event?

Was your team registered as a Phi Theta Kappa team?

What was the name of your team?

Total Funds Raised by Chapter's Team:

Number of Phi Theta Kappa Members on Team:

Estimated Number of Hours Committed to Relay For Life (include planning hours)*: