INDIANA OUTSTANDING PLEDGE AWARD
GENERAL INSTRUCTIONS:
PLEDGES ENTERED MUST HAVE PLEDGED BETWEEN NOVEMBER 1, 2015 AND OCTOBER 31, 2016 (EXAMPLE: Entries submitted for consideration in 2017 must have pledged by OCTOBER 31, 2016.)
Those who pledged after the October 31, 2016 cut-off date will be eligible for entry the following year. The first six months after receiving their jewel pin should be used to complete the entry form. The six months must end NO LATER THAN APRIL 30, 2017.
EXAMPLES: Pledge date October 31, 2016. Six month pledge period ends April 30, 2017. Use this six-month period for entry to be judged and awarded at the June 2017 State Convention.
Pledge date January 1, 2017. Six months ends July 30, 2017. This pledge is not eligible for entry in May 2017, but may be submitted in May 2018.
Entry forms must be received by the Awards Chairman postmarked no later than MAY 15, 2017. They may be mailed to her home prior to that or delivered in person by that date.
Send entries to:
Jennifer Morris
ISC Awards Chair
3307 E Southport Road
Indianapolis, IN 46227
Attached: Entry form (2 pgs)
INDIANA OUTSTANDING PLEDGE AWARD
Name of Pledge: ______
Date Pledged: ______Date of Jewel Pin: ______
(Month, Day, Year) (Month, Day, Year)
Chapter: ______No.:______City: ______
Committees Pledge served on: ______
______
Did Pledge earn First Pearl Award: Yes ______No ______
Did Pledge obtain any Pledges: Yes ______No ______
(During six months time frame for this award)
Attendance:
(DO NOT count any of the following attended before pledge application signed.)
Chapter Meetings: # Held # Attended
Business ______
Social ______
Committee ______
If Chapter business meeting and/or social not held any month during six-month pledge period, please indicate months not active: ______
State/International Council Meetings during pledge period:
Number Held: ______Number Attended: ______
Were the following meetings held during six-month pledge period?
Yes No Did Pledge Attend?
State Leadership Seminar ______
Fall Conference ______
Spring Conference ______
Indiana State Convention ______
International Council Convention ______
Philanthropic and Ways & Means: Please explain fully the work Pledge did to earn hours. For example: Bazaar - knitted afghan, worked days of Bazaar, etc. Use as many lines as necessary to fully explain hours.
Project Explanation No. of Hours
______
______
______
______
______
Describe briefly any other ESA work done, within the time frame for this award, by candidate, not required in duties of any committee served on and NOT covered elsewhere on this form. (Example: Camp Riley Day)
______
______
______
______
______
Chapter President’s Signature Chapter Awards Chairman’s Signature
______
Pledge’s Signature
Please return this form to:
Jennifer Morris
ISC Awards Chair
3307 E Southport Road
Indianapolis, IN 46227
317-223-9716
DEADLINE DATE: MAY 15, 2017