District Governor’s Excellence and Humanitarian Awards 2021-2022
This applications good for the Governor's Excellence Award (GEA) and the District Humanitarian Award (DHA).

Additional club information may be reported below in the spaces provided or at the very end of this form.

MARK ONLY THOSE ITEMS PERTAINING TO THE REPORTING PERIOD.

Eligibility for the Governor's Excellence Award is based on
1.  Monthly submission of membership reports to LCI
2.  Monthly submission of service reports to LCI
3.  Responses per the quarterly submission of this Zone Report

Sign in to Google to save your progress. Learn more
Email *
COMPLETING THE FORM
Print a copy for your records. (Click the three dots/bars in the upper right corner and choose the Print option)

Then, click the Submit button to send your report.

If you have questions or need assistance, contact LION BILL HARNER at ewhar2@gmail.com or 419-368-4137.
Club Name *
Zone *
Report Period *
ADMINISTRATION (all required for GEA)
MEMBERSHIP AND EXTENSION
Any TWO for GEA
Check all that apply.
ATTENDANCE (required for GEA)
Select which Zone Meeting you are reporting for above and then check / list officers and members that attended. Award requires President and Secretary attendance at 2 of the 3 zone advisory meetings.
2021-2022 Officers’ Training School (Zoom orAshland )
FOUR Club representatives must attend. For those unable to attend via zoom, if you emailed DG Kerry and did the replacement activities, please check the box.
 Attended Zone Advisory Meeting 1
 Attended Zone Advisory Meeting 2
 Attended Zone Advisory Meeting 3
REPRESENTATION IN 2021-2022
GEA requires at least THREE of the following.
Check all that apply
SERVICE ACTIVITIES
Count activities only once.  GEA requires at least SEVEN of the following.  DSA requires TWELVE of the following.
Community Activities - local.  Check all that apply.
DONATIONS:International, State & District Projects
(Four required for GEA, Six required for DHA)
PUBLIC RELATIONS
At least THREE of the following
Check all that apply
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms