VETERANS AFFAIRS & REHABILITATION END-OF-YEAR REPORT FORM 2017-2018
Unit entries and Unit Report Forms are due to the District Veterans Affairs & Rehabilitation Chairman
NLT FRIDAY APRIL14th. 2018
(Name and Address of District Chairman on backof form. If there is noone listed mail to the District President.
District# _ _ _ _ Unit Name& #______
Total Unit Membership _
Chairman's Name _
_ _ _ _ _
_ _ _
_ _ _ _
_ _ _
Phone# ______
Address City/Zip _ Email address ______
I
For the above: What did you do? Brief explanation, if you want to report more details, do so in a narrative and auach to this form.
Answer the following Questions:
1. Did any unit member participate in the caregiver program? If yes, describe service given, number of volunteers, total volunteer hours, cost to member/unit and value in-kind donations. Use additional sheet and attach to this form.
2. Describe how members earned Service to Veterans hours. Describe service given, number of volunteers, total volunteer hours, cost to member/unit and value in-kind donations. Use additional sheet and attach to this form.
3. What assistance did unit members give at a stand down? Describe service given, number of volunteers, total volunteer hours, cost to member/unit and value in-kind donations. Use additional sheet and attach to this form.
4. What did units learn about hosting a stand down? What worked; what didn't? Describe service given, number of volunteers, total volunteer hours, cost to member/unit and value in-kind donations. Use additional sheet and attach to this form.
DONATIONS
PROJECT / $AMOUNT / EXPLANATIONVA&R Department Fund / Sent co Dept
Patient Remembrance/Gift Shoo / Sent to Dept
Patient Remembrance /Gift Shoo / Sent to Hospital Rep
Dept President Special Project
Fisher House
Veterans Creative Arts Festival
Others
Did your Unit give out pins/bars recognizing volunteers who reached 50, 100,300,500, 1000 hours? # of pins awarded
# hour bars awarded .
Name of Unit Junior & Senior Service to Veteran Volunteer serving most hours between Apr il 1, 2016 to March 31, 2017. # JR
Hours
# SR Hours
. Junior Volunteer Name: ______SR Volunteer Name: _
Describe their activities on separate sheet of paper.
Did your Unit submit an entry for Unit VA&R Award_____ . Did your Unit submit an entry for Service to Veterans Volunteer
Hours Award______Hour Bar Recognition? . Did your Unit submit an entry for NVCAF Award VAVS
Award
10,000 Hour
20,000 Hour _
Entries for above awards must be typewritten in narrative form not to exceed 1,000 words. Pictures and newspaper articles may be included but not to exceed six pages. Entries can't be in bound book or hard cover. Coversheet must include Unit name and number, address, name of Chairman, address and phone number
District 1 VA&R / District 2 VA&R / District 3 VA&RMarialice Canclini 96 / Barbara Dailey 720 / Laura Faye Sanchez 204
41600 Little River airport Rd / 2070 Martian Way / 1612 3rd St
Little River, CA 95456 / Redding, CA 96002 / Susanville, CA 96130
7079375283 / 5302212688 / 5302572474
District 4 VA&R / District 5 VA&R / District 6 VA&R
Geri Fitzpatrick 807 / Martha Zandejas 77
P O Box 444 / 128 Marin Place
Browns Valley, CA 95918 / Woodland, CA 95695
5307492779 / 5303836042
/
District 7 VA&R / District 8 VA&R / District 9 VA&R
Bonnie Bradbury 169 / Connie Clement 202
155 Sunset Dr / 740 Bramhall St
Auburn, CA 95603 / Brentwood, CA 94513
5308888188 /
District 10 VA&R / District 11 VA&R / District 12 VA&R
Leonie Estigoy 598 / Ruth Briggs 172 / Bonnie Romero 872
1815 Buena Vista Ave / 1225 Linda Place / 2007 Walnut Ave
Alameda, CA 94501 / Tracy, CA 95376 / Ceres, CA 95307
5108812128 / 2098351429 / 2094998210
District 13 VA&R / District 14 VA&R / District 15 VA&R
Joyce McCleod 564 / Karen Varner 110 / Barbara Goodlow 26
2227 Poplar Ave / 30831 Roaring River Dr / 3104 Mt. Vernon Ave
E. Palo Alto, CA 94303 / Coarsegold, CA 93614 / Bakersfield, CA 93306
6503291198 / 5596426246 / 6613040677
/ /
District 16 VA&R / District 17 VA&R / District 18 VA&R
Glenda Powell 66 / Yoko Parsons-crooks 628 / Debra Coplen 755
466 Woodbridge / 9721 La Esperanza / 1389 S. Bender
San Luis Obispo, CA 93401 / Fountain Vally, CA 92708 / Glendora, CA 91740
8055445110 / 7143283459 / 6262521191
/ /
District 19 VA&R / District 20 VA&R / District 21 VA&R
Nancy Butler 496 / Ann Philcox 377 / Mary Ryser 739
4719 Castana Ave / 15455 Glenoaks Blvd Sp 86 / 54245 Ave. Herrara
Lakewood, CA 90712 / Sylmar, CA 91342 / La Quinta, CA 92253
2132000477 / 8183214362 / 7602898320
/ /
District 22 VA&R / District 23 VA&R / District 24 VA&R
June Coatney 460 / Earleen Paige 578 / Deloris Artis 283
6460 Convoy Court #63 / 1831 W. 76th St / 5852 S. Van Ness Ave
San Diego, CA 92117 / Los Angeles, CA 90047 / Los angeles, CA 90047
8583370770 / 3237599270 /
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District 25 VA&R / District 26 VA&R / District 27 VA&R
Judy Samples 256 / Arlene Muller 82 / Rosemarie Todd 457
10616 Quinnqult Rd / 1630 Peck Ave / P O Box 631
Apple Valley, CA 92308 / San Mateo, CA 94401 / Big Pine, CA 93513
7602478915 / 6503447214 / 7609382911
jjalsamples @yahoo.com / /
District 28 VA&R / District 29 VA&R / District 30 VA&R
Karol Adams 31 / Cindy Mayfield 716 / KimVincent 138
246 Terra Dr / 6310 Bataan / 250 Countryside Dr
Salinas, CA 93906 / Cypress, CA 90630 / El Centro, CA 92243
8312063763 / 7143082862 / 7603363058
/ /