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Crusader Award Form
CLUB LEVEL ACCOMPLISHMENTS & CONTRIBUTIONS
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
8	Wrote _____ published articles on Lionism.
9	Spoke to _____ outside groups on Lionism and its goals.
SUB DISTRICT AND MULTIPLE DISTRICT ACCOMPLISHMENTS & CONTRIBUTIONS
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 __________________________
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 ___________________________________________