IOWA LIONS
RALPH A.
WHITTEN SERVICE AWARD
9X9 LIONS
OF THE YEAR
NOMINEE:
Name
______________________
Address ______________________
______________________
Phone
______________________
Club Name ______________________
District
______________________
NOMINATED
BY: Name ______________________
Address ______________________
______________________
Phone
______________________
SERVICE
RECORD OF NOMINEE: Years a
Member ___________
CITE
EXAMPLES OF SERVICE TO LIONISM BY NOMINEE:
CITE
EXAMPLES OF COMMUNITY SERVICE BY NOMINEE:
USE
AS MANY ADDITIONAL SHEETS AS NECESSARY--MUST BE TYPE WRITTEN
RETURN NOMINATION BY JANUARY 15, 2003, TO:
Judy
Terry, Vice District Governor
3575
Hanks Drive SE
Iowa
City, IA 52240