Kinsmen
and Kinettes2001-2002
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Elmer Miller Visitation Award
District 3
Name of Club: _______________________________________________
Club Visited: ______________________________ Date:_____________
VISITING MEMBERS (minimum of 3):
| 1. _____________________________ | 5. _____________________________ |
| 2. _____________________________ | 6. _____________________________ |
| 3. _____________________________ | 7. _____________________________ |
| 4. _____________________________ | 8. _____________________________ |
POINTS AWARDED:
| 1. 3 members visiting (minimum) gives 5 points | = ___5_____ points |
| 2. number of additional visiting members
(maximum of 5) gives 1 point /member |
_________ points |
|
3. travel points- if trip was over 80 kms. use
following: |
= _________ points |
|
TOTAL
|
= ________ POINTS |
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| SIGNATURE OF HOST CLUB PRESIDENT OR EXECUTIVE MEMBER | SIGNATURE OF ONE VISITING MEMBER |
*Submit to current District Awards Director
by April 30th
(name & address in SasKIN or from your Deputy Governor)*
Revised December, 2000