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CLUB LEVEL ACCOMPLISHMENTS & CONTRIBUTIONS
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| During this contest period, this Lion has: |
| 1 |
Completed their _____ year of perfect attendance. |
| 2 |
Served in the Club Office of
_______________________________. |
| 3 |
Secured _____ eye donor cards. |
| 4 |
Sponsored _____ new members into Lionism. |
| 5 |
Reactivated _____ Lions who dropped out of Lionism. |
| 6 |
Worked faithfully on the following club committees:
[ ] Club Improvement
[ ] Membership
[ ] Public Relations
[ ] Leo Club
[ ] Sight
[ ] Hearing
[ ] Youth Work
[ ] Greeter
[ ] Eye Donor
[ ] Bulletin
[ ] Programs
[ ] Budget
[ ] Drug Awareness
[ ] Diabetes
[ ] Visitations
[ ] Projects
[ ] Attendance
[ ] Lion Information
[ ] Convention
[ ] Other |
| 7 |
Done especially outstanding work in
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| 8 |
Wrote _____ published articles on Lionism. |
| 9 |
Spoke to _____ outside groups on Lionism and its goals. |
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SUB DISTRICT AND MULTIPLE DISTRICT ACCOMPLISHMENTS & CONTRIBUTIONS
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| During this contest period, this Lion has: |
| 10 |
Served on _____ district committees |
| 11 |
Attended _____ zone meetings |
| 12 |
Attended _____ cabinet meetings |
| 13 |
Attended _____ Council of Governor Conferences |
| 14 |
Attended _____ Multiple District Convention |
| 15 |
Filled position of _____ on District Governor’s cabinet. |
| 16 |
Worked on the following projects or activities of district.
[ ] Florida Lions Foundation
[ ] Golden Chain Award
[ ] Florida Lions Conklin Center
[ ] Extension
[ ] A Lions Eye Bank
[ ] Membership
[ ] Hearing Aid Bank
[ ] Youth Exchange
[ ] Governor’s Achievement
[ ] LCIF
[ ] Convention
[ ] Leader Dog for the Blind
[ ] Inter-Club Relations
[ ] Florida Lions Camp
[ ] Other |
NOTES:
Each activity indicated above should be explained in a separate paragraph by the nominee in the supplemental information attached. (Enclosure #2)
Please indicate the committee position in which the nominee served (i.e. chair, vice chair, secretary, etc. or member)
Indicate the number of hours involved with each activity, mileage, along with money raised and any other positive results. Do not list money spent. |
If the nomination is made by a Lions Club:
To the best of our knowledge, the information contained on the entry form and the supplementary form are true and correct.
Nominating Club________________________________________________
Presidents Name ________________________________________________
Presidents Signature _____________________________________________
One Other Lions Name ___________________________________________
Signature of other Lion ___________________________________________
Date __________________________
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If the nomination is made by other than a Lions Club:
To the best of our knowledge, the information contained on the entry form and the supplementary form are true and correct.
Name of Organization or Title ______________________________________
Nominating Name __________________________________________
Nominating Signature _______________________________________
One Other Name ___________________________________________
Signature of Lion ___________________________________________
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