Connecticut Future Business Leaders of America

Chapter Recognition Program Entry Form

State Leadership Conference 2015-2016

Connecticut FBLA Chapters must complete 11 of the 18 activities listed below to receive bronze recognition, 13 of the 18 to receive silver recognition, or 15 of the 18 to receive gold recognition. Complete this form by checking the appropriate boxes and return with all required documentation, by February 24, 2016. Chapters who fulfill all requirements will be recognized at the State Leadership Conference.

 / 1.  Nominate at least one member for the Who’s Who in FBLA for Connecticut. Name of Nominee: ______
 / 2.  Attend the State Fall Leadership Conference on October 26, 2015. (Attach a list of members who attended the conference).
 / 3.  Participate in an event for American Enterprise Day (November 15) between November 10 and 17. (Attach a 200 word or less description of the project and its outcome and email a few pictures of the result to . See www.fblapbl.org for details).
 / 4.  Submit a chapter scrapbook for display at the State Leadership Conference. (Attach copy of table of contents).
 / 5.  Submit an annual business report at the State Leadership Conference. (Attach copy of table of contents).
 / 6.  Donate at least five gifts to a charity of one’s choice.
 / 7.  Sponsor an officer candidate for State Office:
Name of member:______Office seeking:______
(Attach a copy of officer candidate’s application)
 / 8.  Submit initial chapter membership by December 1, 2015 (Attach membership list and date the dues were submitted).
 / 9.  Increase membership by 10% or 7 members. The final dues deadline is February 2, 2016 (Attach evidence).
 / 10.  Maintain or establish a local chapter website and or a social media page (Twitter, Facebook, etc.) (Attach copy of home page, link, or Twitter handle).
 / 11.  Bring in two small business owners or influential and motivational speakers to a local chapter FBLA meeting (provide documentation).
 / 12.  Participate in a leadership or community service activity with another local chapter of a CT-CTSO (DECA, TSA, FCCLA, VICA, and FFA) or any other school club (Attach a 200 word or less description)
 / 13.  Participate in a leadership or community service activity with another CT FBLA Chapter.
 / 14.  Re-activate an in-active chapter listed on the CT FBLA Website. (Attach evidence).
 / 15.  Make a Lip-Dub video to any school-appropriate song to be shown at the State Leadership Conference on April 4, 2016. Deadline is February 14th, 2016. Please email the video to . A good example of this type of video can be seen at https://www.youtube.com/watch?v=_01wJMrfLOM
 / 16.  Have at least two members on December 1, 2015 enter the National FBLA Business Achievement Award Programs. Go to http://www.fbla-pbl.org/web/page/662/sectionid/587/fbla.asp for more information. (Attach a 200 word or less description, including a list of members and their level of achievement).
 / 17. Participate in National Programs such as Super Sweeps, Non-Stop November, or February Frenzy. (Attach evidence of
completion).
 / 18. Have at least one member on December 1, 2015 enter the National FBLA Community Service Award Program. To
http://www.fbla-pbl.org/csa2/ for more information (Attach a 200 word or less description, including a list of members
and their level of achievement).

Please mail the completed form to: Lee C. Marcoux, Education Consultant

Connecticut State Department of Education

165 Capitol Avenue, Room #221, Hartford, CT 06106

Fax: (860) 713-7018

Chapter Name: ______Chapter Number: ______

Advisor Name(s):______

Advisor Name(s):______

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