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DISTRICT 9MC FORMS

Official Governor's Visit Request Form
This interactive online form can be used to request an official visit to your club and/or event. Your information is sent directly to your governor.

RALPH A. WHITTEN SERVICE AWARD INFORMATION AND APPLICATION
This award is to honor a Lion who has demonstrated exemplary service and dedication to the ideals of Lionism at any or all levels as well as any other community service organization. It is given in honor of PID Ralph A. Whitten of Urbandale, IA. He served as International Director during the years of 1961-1963. His service exemplified our Lion motto "WE SERVE" by helping his fellow man. Included in this form are instructions and information on selection procedure, as well as the application form.

G. E. "BUD" KLISE LEADERSHIP AWARD AND APPLICATION
The award is to honor the memory of Past International Director G. E. .Bud. Klise of Stockport, Iowa in District 9X4. Lion .Bud. served as District Governor in 1976-77 and as an International Director from 1980-82. Past Director Klise exemplified leadership as he served his fellow man. All others in our International Association who came in contact with Lion .Bud. and his lovely wife Marilyn loved them. His life was cut short by a fatal traffic accident shortly after he had announced that he would be a candidate for the office of International Vice President. Included in this form are instructions and information on selection procedure, as well as the application form.

WARREN COLEMAN HONORARY AWARD APPLICATION -ADOBE PDF FORMAT
This form opens in .PDF format in Adobe Reader. If you do not have Adobe Reader, it is a free download from www.adobe.com. Download this form, print it, fill in the necessary information, and send it to LIONS CLUBS OF IOWA, 2300 SOUTH DUFF, AMES, IA, 50010

WARREN COLEMAN HONORARY AWARD - MICROSOFT WORD FORMAT
This form opens in Microsoft Word Format. You may complete the form by downloading and filling in the shaded areas in Word on your computer, printing and mailing. Or you may simply download, print, fill in the shaded areas by hand and mail to LIONS CLUBS OF IOWA, 2300 SOUTH DUFF, AMES, IA 50010

MELVIN JONES FELLOWSHIP APPLICATION
This form opens in .PDF format in Adobe Reader. If you do not have Adobe Reader, it is a free download from www.adobe.com. The first page of this form is for the Melvin Jones Fellowship, and the second section of this form is for Donations Other Than Melvin Jones Fellowship. Print the form, fill in the necessary blanks, and mail to Lions Clubs International Foundation, 300 22nd Street, Oak Brook, Illinois 60523-8842.

GREAT PLAINS LIONS LEADERSHIP INSTITUTE (GPLLI) 2010
GPLLI, our regional training experience, will be conducted July 16-18, 2010 at Beuna Vista University in Storm Lake, Iowa. Some details that you need to know are as follows: (1) Application forms must be sent to PID Rick Myers, as indicated on the application form; (2) your registration fee must accompany the application form; (3) scholarship assistance may be available from your club, district, or local past district governors club. Please contact your area representative listed on the application form if you need additional information. This form downloads in Adobe PDF format.

PROCEDURE FOR LIONS HEARING AID APPLICATION
1. Referral: Applications of hearing aids should be referred to a local Lions/Lioness club.
2. Evaluation of financial need:
a. Each applicant is evaluated for financial need by the local club. Home visit forms if needed may be obtained from the Hearing Aid Bank or downloaded (see below).
b. If accepted for a hearing aid from the bank a decision is to be made who makes payment of $100 - $150 to the hearing aid dispenser for testing and making of an ear mold, (can be Lions club, client, or cooperative effort). The hearing aid itself is free.
3. The local club will contact a participating hearing aid dispenser with the name, address, phone number of the accepted client and financial arrangements made for payment.
4. The accepted applicant will then make an appointment with the participating hearing aid dispenser contacted by the local club to complete a hearing evaluation to determine the need for amplification. The hearing aid dispenser will call the hearing aid bank for the proper hearing aid.
5. The hearing aid dispenser will submit fitting fees to the participating club, or client as previously arranged.

"ROUND-UP" PROMOTION POSTER - MICROSOFT WORD FORMAT
This form opens in Microsoft Word. In the block "Type the store name", delete those words and type in the retail location. Do the same for your Club name, and enter the date in the blue shaded box. Print copies and post in prominent locations around town.

"ROUND UP" PROMOTION FLYER - MICROSOFT WORD FORMAT
This form opens in Microsoft Word. In the block "Type the store name here", delete those words and type in the retail store name in each of the columns. Do the same for your club name. Scroll down and you will see a second page with information. Print both pages. The second page may be printed on the back of the front page. Then simply copy on a copier, or have a copy shop do it, and cut them into thirds. These are designed to be handed to the person entering the retail location.

"ROUND-UP" PROMOTION TIPS
This document provides tips for your club to hold a successful "Round-Up" project, including a sample copy of a thank-you letter to be sent to the participating retailer.

"ROUND-UP" PROMOTION POSTER - ADOBE PDF FORMAT
This form opens in Adobe Reader. Download, print and fill in form by hand. The green box is for the retailer, the gold box your Lions Club, and the blue is for the date. If you do not have Adobe Reader, it is a free download from www.adobe.com

"ROUND-UP" PROMOTION FLYER - ADOBE PDF FORMAT
This form opens in Adobe Reader. Download, print and fill the form in by hand the shaded areas. The green box is for the retailer, and the gold box is for your club name.You will see a second page with information. Print both pages in landscape format, then print the second page on the back of page one. Then simply copy on a copier, or have a copy shop do it, and cut them into thirds. These are designed to be handed to the person entering the retail location. If you do not have Adobe Reader, it is a free download from www.adobe.com.

WARREN COLEMAN HONORARY AWARD NOMINATION FORM
The Iowa Lions Foundation Warren Coleman Honorary Award is given to a club or individual donating $1,000 to the Iowa Lions Foundation. This may be done at one time or over a three-year period. PDG Sir Warren Coleman joined the Oskaloosa Lions Club in 1948. He served as District Governor in 1957-58. From 1958 to 1988 PDG Coleman served as Executive Secretary/Treasurer of what is known today as the Iowa Lions Foundation. In 1988 he resigned as Treasurer and continued as Executive Secretary for another ten years. In 1998 he was named ex-officio executive Secretary and served in that capacity until his passing on July 31, 2000, having served the Foundation for over 40 years!

MELVIN JONES FELLOWSHIP INFO & APPLICATION
This form includes information regarding the Melvin Jones Fellowship and an application form. This opens in Adobe Reader pdf format. Print the form, fill in the blanks and fax or mail to Lions Clubs International Foundation at the address at the top of the form. If you do not have the Adobe Reader program it is a free download by CLICKING HERE

                                                                                                               

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Ames, Iowa
 
 
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