Fillable Petition for Reactivation Agreement to sponsor/Acceptance of leadership (City of Oakland)

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Petition for Reactivation Agreement to sponsor/Acceptance of leadership (City of Oakland)

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PETITION FOR REACTIVATION- Key Club International
Key Club International is a student-led service organization for high school students. Key Club International was
originally developed by and is modeled after, Kiwanis International, a global network of men and women serving
the children of the world. The stated purpose of Key Club is to develop leadership through service to the school and
community.
KEY CLUB OF:
(Please print, allowing one letter, numeral or space to a box - recommended maximum of 30 characters)
000000000000000000000000000000
Kiwanis District Name:____________________________________ Kiwanis Division:_________________________
Key number (re-charters only): H
00000
This petition is intended to be the unifying document by which the school/community organization and Kiwanis
sponsor agree to meet the requirements of forming and operating an active Key Club. Proper completion and
submission of this petition with club bylaws along with proper payment is the prerequisite for chartering by Kiwanis
International.
Instructions for petitioning:
1. The Kiwanis sponsor of record must complete, in its entirety, page two of this petition. In the case of a
co-sponsor, the second Kiwanis sponsor of record must complete and attach a separate copy of page two.
2. The school administration must complete page three of this petition. Only one Key Club charter is allowed
per school.
3. The member leaders, duly elected by the Key Club members, must complete the Acceptance of
Leadership form
4. The accompanying membership information form must be completed, listing all reactivating charter members
by name, and providing accompanying membership information for each. Use additional sheets as necessary.
(Note: Kiwanis International maintains these names and information for organizational use only. At
no time will Kiwanis International provide membership list to outside organizations.)
5. Mail Reactivation Petition, sponsor agreement, leadership acceptance and member roster with the reactivation
fee.
The following fees must be included in your petition to reactivate:
Reactivation Fee: $100.00
International Member Dues: $7.00/per person
District Dues- this is a per-member fee that is allocated to the Key Club district. To determine your
district dues, please visit https://www.keyclub.org/resources/district-dues/
6. Mail: Kiwanis International, ATTN: Service Leadership Programs Chartering, 3636 Woodview Trace,
Indianapolis, Indiana 46268, USA. Contact Kiwanis International with any questions at 1-800-KIWANIS,
Ext. 411 or slpcharter@kiwanis.org.
Please include the following items when submitting your charter:
Petition for Reactivation
Agreement to sponsor/Acceptance of leadership
Member Roster
Reactivation Fee /International Dues/District Dues
Please send all pieces together. A charter cannot be processed until all items are
received. Thank you.
Page | 2 KEY CLUB PETITION FOR REACTIVATION
AGREEMENT TO SPONSOR A KEY CLUB: A sponsoring organization is not required, but is highly encouraged. If there is
no sponsoring organization, then the school or host site agrees to accept this additional role.
Kiwanis
Club of ______________________________________________________________________ Key number_____________________
Kiwanis
district
____________________________________________
____________
__ Kiwanis division #
____________________________
Notified Kiwanis International to assist locating a sponsoring Kiwanis club but no Kiwanis club is available for sponsorship.
Please include reason(s) for not locating
a Kiwanis sponsor: ____________________________________________________________
__________________________________________________________________________________________________________________
This Kiwanis club hereby petitions that Kiwanis International issue a new club charter for a Key Club at the school/site
specified on page three of this petition. The Kiwanis club agrees to annually support the following Requirements of
Sponsorship for the Key Club:
1. Appoint a Kiwanis advisor to the club and ensure he/she receives adequate orientation.
2. Ensure the advisor attends every meeting or event.
3. Maintain an expense line item in the Kiwanis club’s service account to support the activities of the Key club.
4. Meet with the school principal or organization manager before the beginning of the school year.
5. Ensure all dues and fees are paid.
6. Ensure club officers receive proper training following election.
7. Hold a planning session involving the leadership of the Kiwanis club and the Key club officers.
8. Host or participate in joint activities involving the membership of the Key Club and the Kiwanis club.
9. Invite Key Club members to attend sponsoring Kiwanis club meetings.
10. Ensure Builders Club members are provided training opportunities beyond the club level.
In addition, the Kiwanis club agrees to appoint an active committee of members to support the Key Club and designate one
member as the Kiwanis advisor to the Key Club (print below):
Kiwanis advisors to any sponsored Service Leadership Program will be required to have a criminal background check
cond
ucted and verified by Kiwanis International.
Advisor _________________________________________________________________Member # (if a Kiwanian) _________________
Mailing Address (No PO Boxes)____________________________________________________________________________________
E-mail Address _____________________________________________Telephone ____________________ _Fax ___________________
The ten requirements of sponsorship should be read to the membership of the Kiwanis club at a regular meeting. The signatures
affixed below indicate the acceptance of responsibilities of sponsorship by the Kiwanis sponsor of record, and further indicate the
commitment of the Kiwanis sponsor to provide continuing support for the Key Club, its members and the school. It also is
understood that if the school/site shall request, in writing, that the charter be relinquished, Kiwanis International has the right to
cancel or revoke the charter. In such instance, the Kiwanis club shall forfeit any rights or claim to the Key Club charter or the
school/site. The charter certificate and club materials will be mailed to the Kiwanis club advisor at the address shown above.
In the event the leadership of two Kiwanis clubs intends to co-sponsor the new Key Club, a copy of this form must be completed
and signed by each Kiwanis club. Both forms should be submitted at the time of chartering.
Signatures of Kiwanis club officers:
Signature ________________________________________________ Signature ________________________________________________
Kiwanis Club President
Kiwanis Club Secretary
Print name ________________________________________________ Print name ______
__________________________________________
Date ______________________________ Date ______________________________
If community based, what type of community organization is co-sponsoring:
0 0 0 0
Page | 3 KEY CLUB PETITION FOR REACTIVATION
AGREEMENT TO SPONSOR A KEY CLUB
By the school (or community-based organization*)
School/Organization Name ______________________________________________________ Telephone _______________________________
Address (No PO Boxes) ___________________________________________________________________________________________________
Website__
______________________________________________________________________ Fax_____________________________________
If school, type of school:
Private
Public If US school, NCES school ID: _________________________________
(NCES School IDs can be found at: http://nces.ed.gov/globallocator/)
Home school site/home
BGCA Community Center Church/Synagogue
Other: _____________
School information:
Number of members: ____________ Grade level(s) of members___________________________
This school/organization hereby petitions that Kiwanis International issue a new club charter for a Key Club to be sponsored
by the sponsoring organization of record shown herein. The school/organization agrees to provide the following terms
of sponsorship to support the Key Club:
1. Provide a faculty advisor (print below), designated by the school administration, to advise and counsel the Key Club,
attend all meetings of the club, and ensure the club abides by the regulations of the school and all other local, state/provincial,
and/or federal laws:
Faculty Advisor:______________________________________________Email: ______________________________________
Telephone: _________________________________________________ Fax: ________________________________________
2. Ensure the Key Club conducts service-related projects and activities within the school and community.
*Community-based Club
In the event a school will not allow the organization of a Key Club, a community-based organization with facilities for meeting
and appropriate staff for club advisement may be substituted in place of the school. Such a Key Club must bear a name that represents
the community in which it exists. A staff member or parent must be substituted for and act as the faculty advisor to the club.
For a community-based club, this page of the petition should be completed on behalf of the organization.
The signatures affixed below indicate the acceptance of responsibilities set forth in the terms of sponsorship (shown above) by the
school administration, and further indicate the commitment of the school/organization to provide continuing support for the Key
Club and its members. It also is understood that, at such time the school/organization shall request, in writing, that the charter be
relinquished, Kiwanis International has the right to cancel or revoke the charter. In the case that the Kiwanis sponsor shall no
longer be able or willing to act as sponsor of record, Kiwanis International may choose to seek new Kiwanis sponsorship for the
Key Club.
Signatures of school officials:
Signature _________________________________________________ Signature_________________________________________________
Principal/Organization Administrator Faculty Advisor
Note: Charter Member Roster is a separate Excel/PDF document- can be downloaded at keyclub.org/charter.
Print name ________________________________________________ Print name _
_______________________________________________
Date ______________________________
Date ______________________________
Page | 4 KEY CLUB PETITION FOR REACTIVATION
Acceptance of Leadership: By the KEY CLUB Officers
We, the elected officers of the Key Club, agree to accept and uphold the following items as leaders of
Key Club.
Motto:
Caring–Our Way of Life
Pledge:
I pledge, on my honor, to uphold the Objects of Key Club International; to build my home,
school and community; to serve my nation and world; and combat all forces which tend
to undermine these institutions.
Core Values:
The core values of Key Club International are leadership, character building,
caring and inclusiveness.
Objects:
To develop initiative and leadership.
To provide experience in living and working together.
To serve the school and community.
To cooperate with the school principal.
To prepare for useful citizenship.
To accept and promote the following ideals:
To give primacy to the human and spiritual, rather than to the material values of life.
To encourage the daily living of the Golden Rule in all human relationships.
To promote the adoption and application of higher standards in scholarship, sportsmanship
and social contacts.
To develop, by precept and example, a more intelligent, aggressive and serviceable citizenship.
To provide a practical means to form enduring friendships, to render unselfish service and
to build better communities.
To cooperate in creating and maintaining that sound public opinion and high idealism which
makes possible the increase of righteousness, justice, patriotism and good will.
We also certify the club membership has adopted the Standard Form for Club Bylaws and that we
will, to the best of our abilities, operate this club within the guidelines established within these
bylaws. We agree to abide by school regulations and local, state/provincial, and federal laws. We
commit ourselves to the creation of service and leadership opportunities within this school and
community.
Signatures of Key Club officers:
Print name Signature
Officer
President
____________________________ ____________________________
Vice-
President
____________________________ ____________________________
Secretary
____________________________ ____________________________
Treasurer
____________________________ ____________________________
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Petition for Reactivation Agreement to sponsorAcceptance of leadership (City of Oakland)

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Completed 8 November 2021

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