International Service Award Application
Rotary District 7610 RY 2017-2018
INTERNATIONAL SERVICE AWARD APPLICATION
Club Name______Date ______
Person completing this form______
Contact number______Email______
This Award is for club activities between July 1, 2017 and May 31, 2018.
Please use the District forms provided for your club-submissions. Be sure to briefly describe each activity and also include date of event, number of members and others that participated with the number of hours and financial investment the club and/or members made. This is the same level of event details as required in club submissions for Award of Excellence. Please remember that District and/or RI Foundation data recordings will verify the information for most of these questions.Then please total your club points at the end of the form. Please follow all submission procedures and instructions. No late submissions will be accepted.
For this District award the Foundation related deadlines are earlier than the “usual” June 30th TRF deadline. If Clubs miss this District award’s earlier deadlines please continue to pursue and achieve them by TRF deadline of June 30th. Achieving them by May 31st and/or through June 30th means Clubs may be recognized for those year-end results during the November Foundation Recognition/Awards Dinner.
Also, to qualify for question #4 applications for Global Grant Scholars are due November 15, 2017. To qualify for question #5 submissions re due to Erik Haas by May 15.
The Club has:
(1) Reached100% EREY status with The Rotary Foundation by April 30 (10 points)
(2) Reached 100% Sustaining Membership status with The Rotary Foundation by
April 30 (15 points)
(3) Sponsored an international project with or without the assistance of a grant from the district or from The Rotary Foundation (15 points)
***One (1) additional EXTRA-CREDIT Point for each additional international project that club sponsors.
(4) Submitted one or more applicants for either a Rotary Peace Fellowship or a Global Scholarship (5 points)
(5) Had Club member(s) attend a District Peace Seminar and/or club becomes a certified Rotary District PeaceBuilder Club (5 points)
(6) Hosted or participated in an event in a Rotary-related international celebration or cause(5 points).
(7) Participated, in partnership with another/other Rotary Club(s), in a Rotary District Grant or Global Grant (10 points)
***One (1) additional EXTRA-CREDIT Point for each additional grant in which club participates.
(8) Hosted a Rotary Youth Exchange Student (10 points)
(9) Hosted an event involving Rotary alumni scholars/exchange students and/or Rotarians from another country’s Rotary club (10 points)
(10) Contributed at least $2,000 or more to the Polio Plus campaign (10 points)
(11) Awarded at least one new Paul Harris Fellow or one additional Paul Harris multiple (5 points)
(12)Inducted at least one new Paul Harris Society Members in the Club (10 points)
(13) Signed up an additional club member or another individual to the Rotary Bequest Society (5 points).
Print or type name of Club President: ______Signature: ______Print or type name of Club PI Chair ______Signature: ______
50-60 points Meritorious Award
65-80 points Exceptional Award
85 points and over Exemplary Award
TOTAL POINTS______
***EXTRA-CREDIT POINTSare NOT to be included in the TOTAL POINTS results. Instead, they are to be recorded separately here: ______
Complete and submit NO LATER than May 31, 2018. No late submissions will be considered. Scan completed form and send as an attachment in an email to Pat/Dave Borowski, . Questions please call 703-587-5161.