Gold Key Nomination Form
1
Minnesota - Dakotas District of Key Club International Nomination Form for the 2010-2011 Gold Key Award Nominee's Name: _________________________________ Affiliated Key Club: _______________________________ Nominated by: ____________________________________ To be eligible for this award, the nominee must be an adult individual who has made a significant contribution to Key Club. The nominator must be a Kiwanis Family member. This form and all supporting materials must be received by February 28, 2011. Please send all materials to the District Administrator: Mary Beth Townsend 7508 Jasmine Avenue S. Cottage Grove, MN 55016 The Gold Key is the highest award that can be given by the District to an adult who has made a significant contribution of effort and/or time to Key Club. Selection by the District Board is based on service to the Minnesota - Dakotas District of Key Club International. This is not necessarily an annual award. Any winner or winners will be announced at the District Convention and will be presented the Gold Key plaque and lapel pin. Please attach an essay of approximately 300 words to this form regarding how the nominee exemplifies the merits and ideals of the Gold Key Award. I certify that the attached writing is clearly reflective of the true nature of the nominee, and that all matters of pertinence have been discussed. Nominator's Signature: ________________________ Date: ____________ K E Y C L U B
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I certify that the attached writing is clearly reflective of the true nature of the nominee, and that all matters of pertinence have been discussed. Minnesota - Dakotas District of Key Club International Please attach an essay of approximately 300 words to this form regarding how the nominee exemplifies the merits and ideals of the Gold Key Award. Mary Beth Townsend 7508 Jasmine Avenue S. Cottage Grove, MN 55016 Nominator's Signature: ________________________ Date: ____________
Transcript of Gold Key Nomination Form
Minnesota - Dakotas District of Key Club International Nomination Form for the 2010-2011 Gold Key Award
Nominee's Name: _________________________________ Affiliated Key Club: _______________________________ Nominated by: ____________________________________ To be eligible for this award, the nominee must be an adult individual who has made a significant contribution to Key Club. The nominator must be a Kiwanis Family member. This form and all supporting materials must be received by February 28, 2011. Please send all materials to the District Administrator:
Mary Beth Townsend
7508 Jasmine Avenue S. Cottage Grove, MN 55016
The Gold Key is the highest award that can be given by the District to an adult who has made a significant contribution of effort and/or time to Key Club. Selection by the District Board is based on service to the Minnesota - Dakotas District of Key Club International. This is not necessarily an annual award. Any winner or winners will be announced at the District Convention and will be presented the Gold Key plaque and lapel pin. Please attach an essay of approximately 300 words to this form regarding how the nominee exemplifies the merits and ideals of the Gold Key Award. I certify that the attached writing is clearly reflective of the true nature of the nominee, and that all matters of pertinence have been discussed. Nominator's Signature: ________________________ Date: ____________
K E Y C L U B
