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Distinguished Key Clubber

New York District Key Club

Name _______________ Division _______________
School _______________ President's Name _______________
President's Phone Number _______________

Part ONE: Please complete both of the choices

1. Submit an article to the EMPIRE KEY (please include a copy of the article)

Send to: Cassi Matos
673 Clocks Blvd.
Massapequa, NY 11758
(516) 795-0036
cdolphin84@usa.net
2. Recruit a new Member

Name:_____________________

Part TWO: Please complete 7 of the fifteen listed items OR total 200 points

  1. Attend a Kiwanis Meeting (limit 3)
    Date/Location____________________________________________10 pts.
  2. Attend a Joint K-Family meeting (limit 3)
    Date/Location____________________________________________10 pts.
  3. Participate in a Kiwanis event (limit 3)
    Date/Description____________________________________________15 pts.
    ____________________________________________
  4. Participate in a Joint K-Family event (limit 3)
    Date/Description____________________________________________15 pts.
    ____________________________________________
  5. Submit an Article to Keynoter (include copy of article, limit 3)______5 pts.
  6. Submit article to school/local newspaper (include copy of article, limit 3)_____5 pts.
  7. Chair an event/ committee (describe what you did, etc.)_______________15 pts.
    __________________________________________________
  8. Attend District or International Convention________________1= 20 pts.
    ______________________________________________________Both = 30 pts.
  9. Attend a Regional Training Conference
    Date/Location____________________________________________20 pts.
  10. Attend an Officer's Training Conference
    Date/Location____________________________________________20 pts.
  11. Attend a Divisional (limit 3)
    Date/Location____________________________________________10 pts.
  12. Participate in Governor's Project or Major Emphasis Project
    Date/Description____________________________________________(7 pts./hr; limit 70 pts.)
    ____________________________________________
  13. Participate in a District Project or the Worldwide Service Project
    Date/Description____________________________________________(1pt./$; limit 50 pts.)
    ____________________________________________
  14. Participate in a Read and Lead Project
    Date/Description____________________________________________(7pts./hr; limit 70 pts.) ____________________________________________
  15. 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.

  1. Attend four events
  2. Complete 20 hours of service

Part FOUR:

  1. President's Signature ____________________________________________
  2. 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.com
    Roni Eng
    (Please email or email for mailing address.)
    LtGrrr1115@aol.com

    Deadline: February 15th 2001