2013-14

Governor’s Distinguished Kiwanis Club Award

To qualify as a Distinguished Club during the 2013-2014 Kiwanis Administrative Year, a club must fulfill the new member requirement and complete the five additional items.

After the club has been qualified by the committee, they shall be awarded a special

Distinguished Club Certificate, a unique banner patch, and have their name listed on the New York District web site.

Club: ______Division: ______

We certify that the above has been completed as indicated.

Club President: ______

Club Secretary: ______Date: ___ / __ /_____

Return this form to:

DPP Bob Kueber, Distinguished Kiwanian Chair

67-13 Myrtle Avenue, Glendale NY 11385 Fax: 718-628-0399 E-mail: