2016 BoatU.S. Distinguished Civic Service Award ...



SQUADRON: FORMCHECKBOX orDISTRICT: FORMCHECKBOX ENTRY,Please check one.SQUADRON NAME: FORMTEXT ?????DISTRICT # FORMTEXT ?????CIVIC SERVICE ACTIVITIES: to be completed by the applicantDESCRIPTION: include number of members involved and estimated total cumulative person-hoursShort Term Local Community ActivityMembers FORMTEXT ?????#Hours FORMTEXT ?????#Long Term Local Partnership ProjectsMembers FORMTEXT ?????#Hours FORMTEXT ?????#Promotion of Boating Safety in Community EventsMembers FORMTEXT ?????#Hours FORMTEXT ?????#Representing Squadron or District on Public BoardsMembers FORMTEXT ?????#Hours FORMTEXT ?????#National Safe Boating Week Program(s)Members FORMTEXT ?????#Hours FORMTEXT ?????#Boat Show or Other Public Fairs Booth(s)/ActivitiesMembers FORMTEXT ?????#Hours FORMTEXT ?????#Boating Outreach and USPS Presentations to organizationMembers FORMTEXT ?????#Hours FORMTEXT ?????#Family or Youth Days – Promoting Boating SafetyMembers FORMTEXT ?????#Hours FORMTEXT ?????#Radio/TV Show Appearances Promoting Boating SafetyMembers FORMTEXT ?????#Hours FORMTEXT ?????#Boating Safety Articles Written and Published during yearQuantity FORMTEXT ?????Social Media Sites Developed and Maintained – USPS brand apparentQuantity FORMTEXT ????? List all addresses or paths to the sites so judging committee can review: FORMTEXT ????? FORMTEXT ?????Please include no less than (1) sample of each activity and photographs in electronic format only. Hard Copy of applications and supporting materials will no longer be accepted.Prepare a one-two page summary of how the civic service accomplishments benefitted the community and squadron this year. Include this with the application submission.USPS? NATIONAL REPORT DATA: to be completed by the Judging CommitteeSquadron Membership as of30 September 2015: FORMTEXT ?????30 September 2016 FORMTEXT ?????Public Boating Classes Conducted per Educational Department:# of Classes: FORMTEXT ?????# of Students: FORMTEXT ?????USPS Seminars Conducted per Educational Department:# of Seminars: FORMTEXT ?????USPS Distinctive Communicator Awards: Newsletter: FORMCHECKBOX Yes FORMCHECKBOX NoWebsite: FORMCHECKBOX Yes FORMCHECKBOX NoAchievement in Membership Outreach or Created Outreach Materials: FORMTEXT ?????APPLICATION SUBMITTED BY: deadline 15 October 2016 (Electronic Only)RANK: FORMTEXT ?????NAME: FORMTEXT ?????GRADE: FORMTEXT ?????Squadron/District Position: FORMTEXT ?????Contact Information:Email FORMTEXT ?????Phone #AC ( FORMTEXT ???) FORMTEXT ???- FORMTEXT ????Yes, I have read the detailed explanatory companion document: _ FORMTEXT ????? (please initial)SEND APPLICATION, SAMPLES, and SUMMARY SHEET (electronic by email or flash drives) TO: R/C James Pahl-Washa, JN-IN6929 Donnybill RdDeForest, WI 53532-2614jpwasha@DATE APPLICATION RECEIVED: _ FORMTEXT ????? ................
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