Name _______________ | Division _______________ |
School _______________ | President's Name _______________ |
President's Phone Number _______________ |
Part ONE: Please complete both of the choices1. Submit an article to the EMPIRE KEY (please include a copy of the article)
Send to: Cassi Matos 2. Recruit a new Member
673 Clocks Blvd.
Massapequa, NY 11758
(516) 795-0036
cdolphin84@usa.net
Name:_____________________ Part TWO: Please complete 7 of the fifteen listed items OR total 200 points
- Attend a Kiwanis Meeting (limit 3)
Date/Location____________________________________________10 pts.- Attend a Joint K-Family meeting (limit 3)
Date/Location____________________________________________10 pts.- Participate in a Kiwanis event (limit 3)
Date/Description____________________________________________15 pts.
____________________________________________- Participate in a Joint K-Family event (limit 3)
Date/Description____________________________________________15 pts.
____________________________________________- Submit an Article to Keynoter (include copy of article, limit 3)______5 pts.
- Submit article to school/local newspaper (include copy of article, limit 3)_____5 pts.
- Chair an event/ committee (describe what you did, etc.)_______________15 pts.
__________________________________________________- Attend District or International Convention________________1= 20 pts.
______________________________________________________Both = 30 pts.- Attend a Regional Training Conference
Date/Location____________________________________________20 pts.- Attend an Officer's Training Conference
Date/Location____________________________________________20 pts.- Attend a Divisional (limit 3)
Date/Location____________________________________________10 pts.- Participate in Governor's Project or Major Emphasis Project
Date/Description____________________________________________(7 pts./hr; limit 70 pts.)
____________________________________________- Participate in a District Project or the Worldwide Service Project
Date/Description____________________________________________(1pt./$; limit 50 pts.)
____________________________________________- Participate in a Read and Lead Project
Date/Description____________________________________________(7pts./hr; limit 70 pts.) ____________________________________________- Participate in an Advocacy Project (limit 3)
Date/Description____________________________________________10 pts.
____________________________________________Part THREE: Please complete one of the two choices including dates, descriptions, and # of hours/ $'s raised, ...please use a separate sheet of paper.
- Attend four events
- Complete 20 hours of service
Part FOUR:
- President's Signature ____________________________________________
- Advisor's Signature ____________________________________________
If you have not completed all the requirements but still feel deserving of the DKC award, complete this form to the best of your ability and tell us why you think you should receive the DKC honor.
Please send this form to one of us:
Michelle Blondin
(Please email or email for mailing address.)
Mich9901@hotmail.comRoni Eng
(Please email or email for mailing address.)
LtGrrr1115@aol.com
Deadline: February 15th 2001