Forms by In Seine Newsletter

February 2019

Hotel & Event Ce enter 777 Casino Road, P.O O. Box 41 18 Ma ahnomen, MN USA A 56557 7 April A 26, 27 & 28 8, 2019 1-800 0-453-78 827

WHEN MAKING YOUR Y RESE ERVATION PLEASE U USE CONFIR RMATION N NUMBER 5381 ht + Tax $70.00/Nigght + Tax $65.00/Nigh oom featuress two full beds. This ro oom features two Queen b beds. This ro Ame enities: Refrig gerator, micro owave, coffee e maker, TV

Ame enities: Refrig gerator, micro owave, coffee maker, TV

Park Your Wheels W & En njoy Some Th hrills. Shootting Star’s on-p premise RV park. With a five--star rating from m Wood dall’s Campground Directory, our paved park offers 47

100th Annual MD5M Multiple Convention

Awards, Applications and Forms

Four R Restaurants tto choose from. 2 ONE 8 – Fine e Dining Traditions B Buffet

deluxxe sites comple ete with water, sewer s and elec ctric hookups,

MIN NO WIISINI – E Eat Well Cafe

plus sshower and lau undry facilities. Call (800) 453 3-7827(STAR).

SM MOKE Barbequ ue & Brew

“Catch the Sweet Deal” and join us for the 100th Birthday Party of MD5M

100 Annual MD5M Multiple Convention April 26th, 27th & 28th 2019, Mahnomen, MN, USA

Your District & Club Name: _______________________________________________________________ Lion ___ Lioness ____ Leo ____ Guest ____ 1st TIMER ____ Title & Name________________________________________________ Address ________________________________________________

Registration form also on http://www.lionsmd5m.org

City/Town ________________________________________________ State/Prov. ________________________________________________ Zip/Postal ________________________________________________

“Will you require Braille Documents at the convention? _______

Phone (w/area code) _________________________________________ Email _______________________________________________ Special Dietary Needs: Vegetarian, Gluten Free, Allergies ___________________________________________ I am attending the convention, but NO meals are required, $10.00 cost to attend ____ (Name Tag & Pin) Full Hospitality Book (Includes Friday night Social, Saturday Breakfast, Lunch, Banquet & Sunday Brunch) EVENT Before March 1, 2019 After March 1, 2019 # ATTENDING $ AMOUNT Full Hospitality Book $ 95. USD $ 120. CDN $ 105. USD $ 130. CDN __________ __________ Friday Night Social $ 15. USD $ 20. CDN $ 20. USD $ 25. CDN __________ __________ Saturday Breakfast $ 20. USD $ 25. CDN $ 25. USD $ 30. CDN __________ __________ Saturday Lunch $ 25. USD $ 30. CDN $ 30. USD $ 35. CDN __________ __________ Saturday Banquet $ 40. USD $ 45. CDN $ 45. USD $ 50. CDN __________ __________ Sunday Brunch $ 30. USD $ 35. CDN $ 35. USD $ 40. CDN __________ __________ ***NO Meals available after April 22, 2019*** Totals __________ __________ Make checks payable to: Vergas Lions Memo: 2019 MD5M Convention Mail form & payment to: Linda Norby, 1021 5th Avenue NW, Perham, Mn. 56573 For Convention Information contact: PDG Rodger Palmer, repotter@eot.com or phone 218Ͳ841Ͳ0302 or PDG Jay Norby, ljnorbs@eot.com or phone 218Ͳ298Ͳ1041. Check our website for information & updates on the 2019 MD5M Convention, lionsmd5m.org

Lions 5M11 District Governor Club Visitation Request Form 2018-2019

Todayâ&#x20AC;&#x2122;s Date_____________________ Club:______________________________________ Preferred Date_________________________ Alternate Date:_________________________ Person Requesting___________________________ Phone #___________________________ If more than one club will be attending, please include the names of all clubs: ____________________________________________________________________________ ____________________________________________________________________________ Meeting Time:______________ Social Time:_____________ Dinner Time:_______________ Is Spouse invited:____________ Other District Officers invited:________________________ Location:____________________________________________________________________ Lions Contact Person for visit:____________________________________________________ Phone:______________________________ Cell:_______________________________________ E-Mail:__________________________________ Special requests: (Ex. Special Speech, induction of new members, installation of officers, present awards, etc.)

Please submit as soon as possible. I will confirm date with contact person either by phone or e-mail as soon as possible after request is received. Please send this information to: DG Bill Myskiw R. 204-339-1242 C. 204-782-1416 Email: wjmyskiw@shaw.ca

2018-2019 CLUB EXCELLENCE AWARD APPLICATION Club must be chartered prior to January 1 of the fiscal year to qualify.

Club Number

Application Date

Club Name

Member Number

2018-2019 Club President’s Name

2018-2019 Club President’s Email Address 1.

MEMBERSHIP

Achieved a Net Growth of: ____________ *

SERVICE

Started a new service project. Consider one of our

Global Causes!

Chartered new Lions club or Club Branch: Name of club or branch: ________________________ AND

____________________________________________

Supported member retention by increasing member satisfaction

OR Organized a new Leo Club

Outline strategy: ____________________________ _________________________________________ _________________________________________

AND Contributed to LCIF

*Based on June 30 cumulative membership report

3. ORGANIZATIONAL EXCELLENCE Club is in Good Standing: Not in Status Quo or Financial Suspension. District dues paid and no unpaid balance with LCI greater than US$50 outstanding 90 days or more. AND Key Officers participate in one or more of the following leadership training events:

MARKETING AND COMMUNICATION

The club has publicized its service activities through local media or social media as noted below: _________________________________________________________

___________________________________________ ___________________________________________

District Multiple District International Webinars Lions Learning Center Club Quality Initiative

The club utilized social media to promote club activities and reported to Lions Clubs International as noted below:

AND Improved club operations Improvements Include: __________________________________ ______________________________________________________ ______________________________________________________

Date

_________________________________________________________ _________________________________________________________ _________________________________________________________

2018-2019 District Governor’s Signature*

District

Member Number

Due by: August 31, 2019 Send to: clubexcellenceaward@lionsclubs.org or fax to (630) 706-9245 Awards Mailed to: 2019-2020 District Governors

*If sent from district governor’s registered email, it qualifies as signature on applications submitted electronically. Disqualified clubs have 12 months from original due date to request a review. DA-1.EN 4/18

Heart of a Lion Award Application This Award is for 5M11 lions that meet the criteria below. A lion member may apply or a club may apply on behalf of a member. Applications can be turned in throughout the year. Awards will be awarded at Mid-Winter Convention or at Governors meetings after Convention. This award can be earned over several years. A Lion Member must MEET 7 of the 10 CRITERIA listed below to RECEIVE the AWARD! Name:____________________________________ Club______________________________ (Name of Lion Member) ______ Sponsored a new Lion ___________________________Club_____________________ (Name of new member) ______Attended a Zone Meeting_________________________________________________ ( What Zone and date attended Zone meeting) ______Attended 5M11 Convention. ______Served as a Club officer or District Cabinet Chairperson.________________________ (last position held) ______Be a Chair or Co-Chair of a club or District Project. ____________________________ ( What was the project) ______Attended one training event: Officer Training, Leadership Training or other Lions Clubs International sponsored class. __________________________Date_______________ (Training Attended and date) ______USA/Canada Lions Leadership Forum, International Convention or Multiple Convention. ______Promote a new idea, service project or fundraiser that is adopted by your club or District that meets the mission of Lions. ____________________________________ (Promotion idea and date) ______Attend 5 or more club events _____________________________________________ ___________________________________________________________________ ( Events attended either your club or another club) _______Attend a club meeting of another club______________________________________ (what club) Original to be completed and turned into the District Governor or District Administrator. Signature of District Governor or District Administrator. _______________________Date__________