1 of 23

“How do I use this template?”

Go to “File” at the top left corner
Click “Make a Copy”
Then “Entire Presentation”
Rename the file with your last and first name

Ex: My name is Busy Bee, I’m going to rename

the file to "MotY_BeeBusy”

Lastly, click “Make a Copy”

DELETE THIS PAGE ONCE COPIED

2 of 23

Cover Page

3 of 23

NOMINEE INFORMATION

TABLE OF CONTENTS

Complete the Table of Contents by listing the different focus areas in each application item and by adding the page number for which the listed sections begin. This should also help you place the items in the correct order.

ITEM	FOCUS AREA	START PAGE
Cover Page		1
Nomination Form		2
Section 3	Letter(s) of Recommendation
Section 4	Commitment to Service
Section 5	Commitment to the Core Values of Key Club
Section 6	Proof of Attendance
Section 7	Active membership - Involvement & Accomplishments
Section 8	Kiwanis Family - Fellowship & Unity
Section 9	Personal Contributions
Section 10	Inspirational Qualities

Nominee Name	Division
Nominated By	Region
Key Club	District	California-Nevada-Hawaii
Club Number

CONTINUE ON NEXT PAGE

NOMINATION FORM

CNH District Member Recognition Committee

Questions, Comments, Concerns?

Chloe Hartanto| Member Recognition Chair | mr.chair@cnhkeyclub.org

4 of 23

STATEMENT OF NOMINATION

Please use 12pt Century Gothic font. Word Limit: 500

Why should this member be recognized? How has this member gone above and beyond? How has this member demonstrated the four core values?

NOMINATION FORM

CNH District Member Recognition Committee

Questions, Comments, Concerns?

Chloe Hartanto| Member Recognition Chair | mr.chair@cnhkeyclub.org

5 of 23

NOMINATION FORM

CNH District Member Recognition Committee

Questions, Comments, Concerns?

Chloe Hartanto| Member Recognition Chair | mr.chair@cnhkeyclub.org

6 of 23

Divider: Letter(s) of Recommendation

7 of 23

Letter(s) of Recommendation (max 3 pages)

8 of 23

Divider: Commitment to Service

9 of 23

Commitment to Service

(max 4 pages)

10 of 23

Divider: Commitment to the Core Values of Key Club

11 of 23

Commitment to the Core Values of Key Club

(max 10 pages)

12 of 23

Divider: Proof of Attendance

13 of 23

NOMINEE INFORMATION

CERTIFICATION

The E-Signer must be your Club Secretary or Faculty Advisor. Members may not sign their own forms.

ATTENDANCE

You may list a maximum 40 Projects, Activities, Events (DCMs, Training Conferences, etc.). Be sure to provide a variety of different projects, activities, and events. Must follow the virtual service hour requirements found on the Cyberkey.

*Club, Division, Region, District, International

Nominee Name	Division
Nominated By	Region
Key Club	District	California-Nevada-Hawaii
Club Number

Project, Activity, Event	Date (MM/YYYY)	Level of Activity*	Service Hours
1
2
3
4
5
6
7
8
9
10
11
12

INITIALS	POSITION	E-SIGNATURE	E-MAIL	PHONE W/ AREA CODE
	Club Secretary
	Faculty Advisor

PROOF OF ATTENDANCE

CNH District Member Recognition Committee

Questions, Comments, Concerns?

Chloe Hartanto | Member Recognition Chair | mr.chair@cnhkeyclub.org

14 of 23

Project, Activity, Event	Date (MM/YYYY)	Level of Activity*	Service Hours
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
Total Service Hours

PROOF OF ATTENDANCE

CNH District Member Recognition Committee

Questions, Comments, Concerns?

Chloe Hartanto | Member Recognition Chair | mr.chair@cnhkeyclub.org

15 of 23

Divider: Active membership - Involvement & Accomplishments

16 of 23

Active membership - Involvement & Accomplishments

(max 10 pages)

17 of 23

Divider: Kiwanis Family - Fellowship & Unity

18 of 23

Kiwanis Family - Fellowship & Unity

(max 3 pages)

19 of 23

Divider: Personal Contributions

20 of 23

Personal Contributions

(max 4 pages)

21 of 23

Divider: Inspirational Qualities

22 of 23

Inspirational Qualities

(max 4 pages)

23 of 23

“I’m finished with my E-Portfolio, how do I submit it?”

Go to “File” at the top left corner
Click “Download”
Then “PDF”
Once downloaded, head to your email service and draft an email as instructed in the guidelines (or below).

DELETE THIS PAGE ONCE COPIED