Pacific Northwest District Achievements and Awards Club Name ______________________________________________________ Club # ________________________________ Zone # ________________ Club Membership ____________ Quarter 1 ___ 2 ___ 3 ____ 4 ____ Participation in OI projects: Youth Appreciation 50 points ____ Essay Contest 50 points ____ Oratorical 50 points ____ Youth Cancer 50 points ____ CPA book 50 points ____ Law and Order 50 points ____ Officer Elect Report (on time) 100 points ____ Annual Activities (on time) 100 points ____ Optimist International Foundation: 4th Quarter (30 Sep 2003) Contrib $_____ #members ____ = $____ /member $____ X 100 = ____ New Club Built: 1000 points ____ X 1000 = ____ Bonus (clubs built between 1Oct02 and 31Mar03) 1000 = ____ Conference Attendance 250 pts per Pres/Sec/Treas or Proxy ____ x 250 = ____ Members At Training (attach verification) ____ x 100 = ____ Zone Meetings: Pres/Sec per Qtr ____ x 100 = ____ Club Visitations: min 5 members per visit ____ x 100 = ____ International Convention Attendance 100 = ____ Banner Displayed at conferences 50 = ____ Club Bulletins: Months published at least one ____ x 25 = ____ Bulletins in excess of one per month ____ x 10 = ____ Add Members each quarter ____ x 25 = ____ Delete members ____ x-10 = ____ Participation in other Youth Projects ____ x 100 = ____ Fund raisers for youth ____ x 100 = ____ (Attach list of projects for each quarter.. Thank you) Meeting Attendance - Minimum 25% each meeting 150 = ____ Dues: current each quarter 200 = ____ Optimist of Quarter chosen by Lt. Gov 100 = ____ Grand Total = ____ Club President or A&A Chairman ________________ Sig__________________ Lt. Gov ________________________Sig ______________________________