President’s Citation
RECOGNITION BY CLUBS
President’s Citation to recognize outstanding Member achievement
Only the 2018-2019 Club President may make application, and it must be received in the International Office no later than August 31, 2019.
Only one recipient per Club will be accepted. The citation will be shipped to the 2018-2019 President for presentation to Member.
PLEASE TYPE OR PRINT
Submit to: Recognition Department, Optimist International, 4494 Lindell Blvd., St. Louis, MO 63108 USA
FAX: (314) 371-6006 E-mail: moorej@optimist.org
Recipient’s Name: __________________________________________________ Club Number: ____________________________
Club Name: ____________________________________________________ Member Number: ____________________________
District Name: ______________________________________________________________________________________________
Submitted by (Club President):_________________________________________________________________________________
Street Address of Club President: _______________________________________________________________________________
City: _____________________________________________________ State/Province:_______________ ZIP: ________________
Phone of Club President: ( ) ___________________________________ (Cell)
( ) ______________________________ (Residence)
( ) ________________________________(Business)
E-mail: _____________________________________________________________________________________________________