Fillable Membership Sponsor Award Application Membership_Sponsor_Award_Application

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Membership Sponsor Award Application Membership_Sponsor_Award_Application

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REQUEST FOR MEMBERSHIP SPONSOR AWARDS
This certifies that the following member has qualifiedfor a sponsor award under the category indicated below:
(Select one)
Accumulative: 10 Members 25 Members 50 Members 75 Members 100 Members
125 Members 150 Members 175 Members 200 Members 225 Members
250 Members
SPONSOR INFORMATION
Club Name ____________________________________________ Club # _______________________________
Sponsor’s Name ____________________________________ Member # _______________________________
Sponsor’s Address ____________________________________________________________________________
NEW MEMBER INFORMATION
# Name Club # Date Enrolled*
1. ____________________________________________________ ___________________________ ______________
2. ____________________________________________________ ___________________________ ______________
3. ____________________________________________________ ___________________________ ______________
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22. ____________________________________________________ ___________________________ ______________
23. ____________________________________________________ ___________________________ ______________
24. ____________________________________________________ ___________________________ ______________
25. ____________________________________________________ ___________________________ ______________
*Date must be provided. When not sure, provide approximate date. Attach separate list of any members over 25 for specific award.
Certified: Club Secretary-Treasurer _______________________________________ Club # ______________
Club Sec/Treas Address_____________________________________________________________
New member awards are cumulative;the members secured for one award apply toward the next award. Charter members of new clubs do not
count toward new member sponsor awards. New members must be formally processed and added to the club roster at the International Office
before the awards can be supplied. The Accumulative Awards are provided for sponsoring new members over the length of time the members has
been with the organization.
Instructions: Please type or print carefully. Complete a request for each member who is to receive any sponsor award.
Mail to Optimist International, 4494 Lindell Blvd., St. Louis, MO 63108. Keep a photo copy for club records.
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Membership Sponsor Award Application Membership_Sponsor_Award_Application

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Completed 3 July 2020

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