Jurisdiction Silver Rose Chairman:
Once the Silver Rose has completed its pilgrimage through your jurisdiction, add the total number of runners (if any) involved
in carrying the Rose from location to location and estimate the total number miles traveled by the Rose in your jurisdiction.
Jurisdiction: ____________________ Total Services: ___________ Total Attendees: ___________
Runners (if any): ________________ Total Miles Rose Traveled in Jurisdiction: ________________
State Chairman Signature: ___________________________________________________________
10721 11/19
LIFE
FAITH IN ACTION
Email a copy of this document to: fraternalmission@kofc.org
(Councils should also retain a copy of this completed form for their files)
SILVER ROSE
LOG
FORM
Number of Number of Miles
Sponsoring Council Name/Number Location Date Services Held Attendees Traveled
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