Club Communications Award Form Dana A. Lackey Club Communications Award All nominations must be submitted to the District Board no later than the Winter Board meeting, or they will not be considered. District Board members may submit a nomination following the above format at the Winter Board meeting. Nominations not in the above format will not be considered. The District Board reserves the right to decline to present this award in a year when it is determined that there are no qualified nominees. Your Email*Please list your current email so that we can contact you should an issue occur. Address*Provide the club's mailing address to which the award can be sent if needed. Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Circle K Chapter*Alabama State UniversityAuburn UniversityBirmingham Southern CollegeCoastal Alabama Community CollegeEnterprise State Community CollegeGadsden State Community College - GadsdenJacksonville State UniversityTroy UniversityThe University of AlabamaUniversity of Alabama at BirminghamUniversity of Alabama at HuntsvilleUniversity of North AlabamaUniversity of South AlabamaAward Form Upload*Upload the complete excel award form which can be found by clicking on the button at the top of the page.Accepted file types: xls, xlsx.Circle K Club President Signature*Circle K Club Secretary Signature*Kiwanis or Faculty Advisor Signature* Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.