Club or Unit Name _____________________________	State ____________)______
Club or Unit Contact Person _____________________	Phone Number ____________

To qualify for this award the club or unit must do all of the following:

1. Be represented at TWO of the following:

   District or Region Meeting	Yes______ No_____ Date _________
   Annual State Conference or Meeting	Yes______ No_____ Date _________
   National FCE Conference	Yes______ No_____ Date _________
   Mid-Year Leadership Seminar	Yes______ No_____ Date _________
   FCL Day at National Conference	Yes______ No_____ Date _________



2. Collect National FCE dues for all group members and mail
   

   by the established deadlines.

   Yes______ No_____ Date _________




3. Participate in a national, state or local membership drive.

   Yes______ No_____ Date _________



4. Use at least four (4) National education programs
   per year. List them here: 1.____________2._____________3.______________4.________________


5. Provide two (2) sessions of leadership training to members from any of the approved FCL materials available from National FCE. List programs here: 1.___________________ 2.______________________


6. Participate in one community action project, networking with one or more groups. Apply for the Community Service Award from the National Association for Family and Community Education as outlined in the National FCE handbook. Name of project and date completed: ______________________


7. Send in all required reports on time.


8. Participate in National FCE Week the 2nd full week in October, and list your activity(ies) here:
         1._______________________


9. Participate in the Public Relations program as outlined in the National FCE handbook. Fill out the Public Relations Report Form and mail by the established date to appropriate National Board Member.