“The Heart of Key Club” 2010-2011 District Project Completion Form
Club ID Number:___________________ High School:_____________________________ Division:________ Region:________ Faculty Advisor: ____________________ President: ________________________ Phone: ___________________________ Phone: ____________________ Email: _____________________________ Email: ______________________ Number of Members in Club: _______ Please fill out page two for each of the categories in “The Heart of Key Club” District Project.
Please remember to submit ALL proof with your completed application. In addition, please submit any pictures of your club participating in the project with your application. Please submit these with a CD or email them to Megan Iselin at by March 1, with your club information (name of club, short picture synopsis, faculty advisor name). Thank you very much for participating in this year’s project! The Texas-Oklahoma District Board is so glad to see so many of the district’s Key Clubbers participating in efforts to help the Heart of Key Club! In Service, Megan Iselin Lt. Governor Division 3N / Chairwoman District Project Committee Signatures: I hereby declare that all information above and attached is correct and that everything above is what our club did to participate in the 2010-2011 T-O Key Club District Project “The Heart of Key Club.” Faculty Advisor _________________________________________ Date _________________

Club President _____________________________________________ Date _________________ Completion forms MUST be postmarked by March 1, 2011 to: Megan Iselin 15211 Wisteria Springs Dr. Cypress TX 77433

Check one:





In the following section, please list and describe the project(s) that your club did this year for the category checked above. It is perfectly acceptable to only put one project completed for the category. If more room is needed, please type a summary sheet in a word processing program and submit it with the completion form. Please include sign-in sheets (with project times listed) as proof of service. Date of Project   Project Description Number of Members Participating   Total Man Hours  


If applicable, in the following section, please list the number of items your club collected and where the items were donated. Please have a letter or receipt as proof of your donation. Items Collected (Amount and Type) Place of Donation

In the following section, please share some of your club’s experiences in working with this category checked above. It can be a story, a quote, and a project summary, anything you would like to share with the district. You can also include quotes to be used at DCON.

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