RAY ALLEN NOMINATION FORM (CONT’D.)
FOR THE ADMINISTRATION YEAR 2017-18
RAY ALLEN AWARD NOMINATION FORM
Hailing from Division 8 (Huronia), Ray Allen served Kiwanis as EC&C Governor (1969 -1970), 4 years as International Trustee and as International Vice President (1985-1986). Ray cofounded the Kiwanis Foundation of Canada and was instrumental in moving our International office to Indianapolis from Chicago in 1982.
His motto as Governor was “Get Involved in Community Service”. This award named in his honour recognizes Outstanding Kiwanis Service by a Past Lieutenant Governor in EC&C District.
PURPOSE:To recognize Past Lieutenant Governors who have continued, for at least 5 years, to contribute and participate in the activities of his/her Club, Division and District.
Name: ______LG. Class of ______
of the Kiwanis Club of ______
Division No. ______Division Name: ______
______has continued, for at least 5years, to contribute and participate in the activities of his/her Club, Divisionand District since serving as a Lieutenant Governor.
MOTION TO NOMINATE: Adopted by Division Caucus/Council meeting held on:
______, 20___, at ______
DATEPLACE
NOMINEE’S INFORMATION:
CLUB ACTIVITIES, PROGRAM, EVENT INVOLVEMENT SINCE SERVING AS THE DIVISION LIEUTENANT GOVERNOR
Board Member: Yes ___ No ___ Position(s) and year(s) ______
Executive Member: Yes ___ No ____ Position(s) and year(s) ______
Committee/Project/Event Involvement (year):
- ______Chair: Yes ___ No ___
- ______Chair: Yes ___ No ___
- ______Chair: Yes ___ No ___
- ______Chair: Yes ___ No ___
Other Roles (i.e. Bulletin Editor, Club Historian) ______
Sponsor of new members Yes ____No ___ If yes how many _____What year(s) ______
Inter club Attendance: Number attended _____
Additional comments: (i.e. Service Leadership Program involvement, involvement for the good of Club)______
DIVISION ACTIVITIES, PROGRAM, EVENT INVOLVEMENT SINCE SERVING AS LIEUTENANT GOVERNOR
Caucus/Council Chair:Yes ____Year ______Name: ______No ___
Division Committee Member: Yes ____ Year ______Name: ______No___
PLG Committee Chair:Yes ____ Year______Name: ______No___
Caucus/council Meeting attendance Record: Number ______
Additional comments:
______
DISTRICT/INTERNATIONAL ACTIVITIES, PROGRAMS, COMMITTEES, EVENTS
Delegate District Convention: Yes ___ Year(s)/location(s)______No ___
Delegate International Convention: Yes ___Year (s)/location(s) ______No ___
Committee Chair:Yes ____ Year(s)______Name: ______No___
Committee Member:Yes ____ Year(s)______Name: ______No___
PLG Committee attendance at District convention Yes ____ Year(s)______No_____
Additional comments:
______
SUBMIT NOMINATION TO:
District PLG Committee Chair: DLG Bob Bogardis
DEADLINE DATE: APRIL 7, 2018
Submitted Date: ______
Submitted by Lieutenant Governor ______
Division: ______
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