Months
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Jan
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Feb
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Mar
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Apr
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May
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June
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July
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Aug
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Sept
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Oct
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Nov
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Dec
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MCRTA Enter
Hrs
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Church
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Community
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Education
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Other
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Total Hours
For Year
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Name_______________________________
Address______________________________
| When this form is finished, please send it to the MCRTA President by December 15th so that it may be included in the ORTA report due in January. Thank you for sharing. PRESIDENT OF MCRTA, Patricia Love 3734 Whisper Creek Drive Vandalia, OH 45414
To print this form, right click and press PRINT.
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