Page 21 - District 20-K1 Kings & Queens Fall Editon E-Newsletter 2022

PDG Earl and PDG Ruth Williams Distinguished Service Award
(You are advised to read the attached guidelines before applying for this award)

PLEASE PRINT

APPLICANT’S NAME: ____________________________CLUB________________________
ADDRESS: __________________________________________
EMAIL:_____________________________________________
PHONE:_____________________________________________

Check What Applies:
I have been an ACTIVE Lion in a lion’s club (20-K1) for 25+ years. I
I have served as President of a Lions Club in (20-K1)

I have served on the District Level. I have served on the Multiple District Level
List position/s held and year/s served List position/s held and year/s served

________________________________YR________ ____________________________________YR________
________________________________YR________ ____________________________________YR________
________________________________YR________ ____________________________________YR________

Tell your story of service (100 words or less): (more space? Use reverse side of application)
______________________________________________________________________________________________________
______________________________________________________________________________________________________
________________________________________________________________________________________________________
____________________________________________________________________________________________________________

Why do you think you are deserving of this award? (100) words or less) (more space? Use reverse side of
application)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________

Nomination submitted by:
Club Name: ______________________________________
PDG Name: ________________________________

Applicant’s Signature___________________________________
Club President’s Signature______________________________
PDG’s Signature________________________________________(if Nominator)

Applications must be received by December 30, 2022. NO EXCEPTIONS
Please mail completed application to:
PCC Gloria Askew
441 Hegeman Avenue
Brooklyn, NY 11207
You may email your application to any of the email addresses listed below
PCC Gloria Askew gvaskew41@aol.com
PDG Clarence R.A. Higgins crahiggins@aol.com
PDG Joyce L Cochran deltalion2@aol.com