Outstanding Project Award Form
Instructions
The banner patch award program is designed to recognize exemplary projects that address the needs of young children. The purpose of this program is to encourage all clubs to develop, manage, and participate in projects that provide meaningful service to children and their community. The project must be nominated by the lieutenant governor, district chairman for Young Children: Priority One, district governor, or International officer. The form can be completed online, submitted by postal mail, or faxed to the International office.

 * Required
CLUB NOMINATED
 Kiwanis club of: *  
 Key number: *  
 Club contact: *  
Telephone:
 E-mail: *    
Date project was completed: *    
Project description: *     
Funds spent: US$
Number of service hours:  
Number of children served: *    
Did the club work with outside organizations? If so, please list:
TYPE OF AWARD *  
Clubs that have already received a four-year banner patch will receive a pin designating the current year. Clubs that have not received a four-year patch will receive a patch and pin. Please choose one below:
NOMINATOR
The nominator will receive the banner patch award and is responsible for presenting it to a club representative.
 Nominator's name: *  
Telephone:
 E-mail: *    
Address:
City:
State/Province:
Postal Code:
Country:
Title:
District:
Special instructions:
 

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