District Governor’s Excellence, Service and Humanitarian Awards 2019-2020
This applications good for the Governor's Excellence Award (GEA), as well as the District Service Award (DSA) 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
Email address *
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.
Email Address *
Your answer
Club Name *
Your answer
Zone *
Your answer
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.
2019-2020 Officers’ Training School
TWO Club representatives must attend.
Attended Zone Advisory Meeting 1
Attended Zone Advisory Meeting 2
Attended Zone Advisory Meeting 3
REPRESENTATION IN 2019-2020
GEA requires at least TWO 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.
Community Activities - world. Check all that apply.
Youth Activities. Check all that apply.
Lions District Activities. Check all that apply.
Other Activities
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
Total Service Hours
(This reporting period ONLY)
Your answer
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