KEY CLUB

Barbara Goleman Senior High School

14100 NW 89 TH AVE, ROOM 1-125 MIAMI LAKES, FL 33018-1384 USA ● (305) 362-0676

Officer Application
2010-2011
ID Number: __________________ Grade: ________

Name: ___________________________ Birthday: _____________________

Class of: 2011 2012 2013 2014

Number of Years Previously in Key Club: 1 2 3

Which Key Club officer position do you aspire to hold?

_________________________

Why do you feel you are the most qualified person for this position? [Give
SPECIFIC examples of activities you have organized, implemented, or
supervised.]

What other commitments do you have for the following year (positions in
other clubs, sports, jobs, etc.)?

List your goals for the upcoming Key Club year:

a Kiwanis-family member
ke y c l u b . o rg

Developing competent, capable, and caring leaders since 1925.

 KEY CLUB
Barbara Goleman Senior High School

14100 NW 89 TH AVE, ROOM 1-125 MIAMI LAKES, FL 33018-1384 USA ● (305) 362-0676

How much time (per week) will you dedicate to Key Club?
_______________________

Applicant’s Signature: ________________________________

Date:__________________

In order to be considered for this position, you need two recommendations.

In the space below please obtain the signatures of two of your current
teachers. Their signatures and comments should attest to your leadership
potential.

Comments:

Teacher’s Name: ______________________________

Signature:________________________

Comments:

Teacher’s Name: ______________________________

Signature:________________________

Please return this form to Mrs. Calleiro in room 1125

no later than January 8, 2010.

a Kiwanis-family member
ke y c l u b . o rg

Developing competent, capable, and caring leaders since 1925.

 KEY CLUB
Barbara Goleman Senior High School

14100 NW 89 TH AVE, ROOM 1-125 MIAMI LAKES, FL 33018-1384 USA ● (305) 362-0676

This section to be completed by Advisor

Date Application Turned in: _____________ Date Dues Paid: ___________

Date Inducted into Club: ______________

Number of Community Service Hours: _____

Amount of Money Raised through Fundraisers: ___________

Amount of Money Still Owed to Club: ____________

Amount of Money Raised for Charities: ___________

Date of Approval/Disapproval: ____________ Approved: _______ Not Approved:

________

Reason:
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Advisor’s Signature: ____________________________________________________

a Kiwanis-family member
ke y c l u b . o rg

Developing competent, capable, and caring leaders since 1925.