LIONS CLUBS OF IOWA FORMS

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MAKE A DIFFERENCE DONATION FORM
To make a recurring or ongoing donation to the Iowa Lions Foundation or Lions Clubs International Foundation (LCIF)download this form and follow the instructions on how do leave a legacy to service!

2017 MID-WINTER LEADERSHIP CONFERENCE ADVERTISING POLICIES
This is the 2017 Mid-Winter Leadership Conference Advertising Policies. If you are interested in advertising in the Mid-Winter Booklet please download this form and contact Lion Jeanine Luetters at the contact information listed on the form.

LCI WOMEN'S MEMBERSHIP SEPTEMBER NEWSLETTER
Read the LCI September Women's Membership newsletter. In it the MD9 Women's Regional Workshop is Featured.

CENTENNIAL SPEECH CONTEST PACKET
Here you can download all the material for the Iowa Lions Centennial Speech Contest! Get started today!

RALPH A. WHITTEN SERVICE AWARD INFORMATION AND APPLICATION
This award is to honor a Lion who has demonstrated exemplary service and dedication to the ideals of Lionism at any or all levels as well as any other community service organization. It is given in honor of PID Ralph A. Whitten of Urbandale, IA. He served as International Director during the years of 1961-1963. His service exemplified our Lion motto "WE SERVE" by helping his fellow man.
Included in this form are instructions and information on selection procedure, as well as the application form. The form is in Adobe PDF format, and may be filled in from your computer, printed out, and mailed per instructions on the form. All blanks are fillable, including the nominee's service as a Lion Member, and other community services. Additional typewritten or computer printed pages may be added if necessary.

G. E. "BUD" KLISE LEADERSHIP AWARD AND APPLICATION
The award is to honor the memory of Past International Director G. E. .Bud. Klise of Stockport, Iowa in District 9X4. Lion .Bud. served as District Governor in 1976-77 and as an International Director from 1980-82. Past Director Klise exemplified leadership as he served his fellow man. All others in our International Association who came in contact with Lion .Bud. and his lovely wife Marilyn loved them. His life was cut short by a fatal traffic accident shortly after he had announced that he would be a candidate for the office of International Vice President.
Included in this form are instructions and information on selection procedure, as well as the application form. The form is in Adobe PDF format, and may be filled in from your computer, printed out, and mailed per instructions on the form. All blanks are fillable, including the nominee's offices held, and awards received. Additional typewritten or computer printed pages may be added if necessary.

LIONS OF IOWA "SPARK PLUG" AWARD
A spark plug starts an engine and keeps it in motion.
The Spark Plug Award honors Lions who give that same spark to a Lions' project, club or district. It's purpose is to recognize and encourage emerging Lion leaders for their energy, creativity and inspiration to others.
Download this form, fill it out and send it to PID Dave Stoufer by February 28th!

WARREN COLEMAN HONORARY AWARD APPLICATION -ADOBE PDF FORMAT
This form opens in .PDF format in Adobe Reader. If you do not have Adobe Reader, it is a free download from www.adobe.com. Download this form, print it, fill in the necessary information, and send it to LIONS CLUBS OF IOWA, 2300 SOUTH DUFF, AMES, IA, 50010

WARREN COLEMAN HONORARY AWARD - MICROSOFT WORD FORMAT
This form opens in Microsoft Word Format. You may complete the form by downloading and filling in the shaded areas in Word on your computer, printing and mailing. Or you may simply download, print, fill in the shaded areas by hand and mail to LIONS CLUBS OF IOWA, 2300 SOUTH DUFF, AMES, IA 50010

MELVIN JONES FELLOWSHIP APPLICATION
This form opens in .PDF format in Adobe Reader. If you do not have Adobe Reader, it is a free download from www.adobe.com. The first page of this form is for the Melvin Jones Fellowship, and the second section of this form is for Donations Other Than Melvin Jones Fellowship. Print the form, fill in the necessary blanks, and mail to Lions Clubs International Foundation, Department 4547, Carol Stream, IL 60122-4547.

IOWA LIONS HEARING AID BANK PROCEDURES AND APPLICATION FORM FOR HOME VISIT
1. Referral: Applications of hearing aids should be referred to a local Lions/Lioness club.
2. Evaluation of financial need:
a. Each applicant is evaluated for financial need by the local club. Home visit forms if needed may be obtained from the Hearing Aid Bank or downloaded here.
b. If accepted for a hearing aid from the bank a decision is to be made as to who makes payment of $100 - $150 to the hearing aid dispenser for testing and making of an ear mold, (can be Lions club, client, or cooperative effort). The hearing aid itself is free.
3. The local club will contact a participating hearing aid dispenser with the name, address, phone number of the accepted client and financial arrangements made for payment.
4. The accepted applicant will then make an appointment with the participating hearing aid dispenser contacted by the local club to complete a hearing evaluation to determine the need for amplification. The hearing aid dispenser will call the hearing aid bank for the proper hearing aid.
5. The hearing aid dispenser will submit fitting fees to the participating club, or client as previously arranged.

CENTRAL IOWA LIONS EYE TISSUE TRANSPORT PROGRAM APPLICATION & CONFIDENTIALITY AGREEMENT
If you would care to serve by volunteering to participate in the relay of donated eye tissue to the Iowa Lions Eye Bank in Iowa City, please download, print out, fill in and sign BOTH the Transport Application and the Confidentiality Agreement.

Return both forms to: Iowa Lions Eye Bank, Bio Ventures Center, 2500 Crosspark Rd., W300,
Coralville, IA 52241


This form is in Adobe PDF format.

EASTERN IOWA LION EYE TISSUE TRANSPORT PROGRAM APPLICATION & CONFIDENTIALITY AGREEMENT
If you would like to volunteer to participate in the relay of prepared Wisconsin eye tissue from the Iowa Lions Eye Bank in Iowa City to meet the Wisconsin Lions in Dubuque, please download, print out, fill in and sign BOTH the Transport Application and the Confidentiality Agreement.

Return both forms to: Iowa Lions Eye Bank, Bio Ventures Center, 2500 Crosspark Rd., W300,
Coralville, IA 52241


Memorial Brick Form
This is the form used to request a brick or a paver be placed at the Lions Of Iowa State Office. Details of the cost are included on the form.

"ROUND-UP" PROMOTION POSTER - MICROSOFT WORD FORMAT
This form opens in Microsoft Word. In the block "Type the store name", delete those words and type in the retail location. Do the same for your Club name, and enter the date in the blue shaded box. Print copies and post in prominent locations around town.

"ROUND UP" PROMOTION FLYER - MICROSOFT WORD FORMAT
This form opens in Microsoft Word. In the block "Type the store name here", delete those words and type in the retail store name in each of the columns. Do the same for your club name. Scroll down and you will see a second page with information. Print both pages. The second page may be printed on the back of the front page. Then simply copy on a copier, or have a copy shop do it, and cut them into thirds. These are designed to be handed to the person entering the retail location.

"ROUND-UP" PROMOTION TIPS
This document provides tips for your club to hold a successful "Round-Up" project, including a sample copy of a thank-you letter to be sent to the participating retailer.

"ROUND-UP" PROMOTION POSTER - ADOBE PDF FORMAT
This form opens in Adobe Reader. Download, print and fill in form by hand. The green box is for the retailer, the gold box your Lions Club, and the blue is for the date. If you do not have Adobe Reader, it is a free download from www.adobe.com

"ROUND-UP" PROMOTION FLYER - ADOBE PDF FORMAT
This form opens in Adobe Reader. Download, print and fill the form in by hand the shaded areas. The green box is for the retailer, and the gold box is for your club name.You will see a second page with information. Print both pages in landscape format, then print the second page on the back of page one. Then simply copy on a copier, or have a copy shop do it, and cut them into thirds. These are designed to be handed to the person entering the retail location. If you do not have Adobe Reader, it is a free download from www.adobe.com.

Nebraska/Iowa Coalition of Vision Resources
This brochure has been developed by the Coalition of Vision Resources to educate Nebraskans and Iowans about the continuum of vision services available. Listed is contact information and background on the organizations participating. Questions may be directed to the perspective organization.