Name of Nominee: 

Address of Nominee: 

Member of Altrusa International Inc. of

Each club may nominate one candidate per year for the Outstanding Altrusan Award.  It is based on outstanding service over a period of years and recognizes an Altrusan who is "your club's unsung hero."  Most weight in judging will be placed with your nominee's activities that support your club's service, communications, literacy and membership.

Members previously honored by District Seven with a Lamplighter Award are not eligible for this award.  Nominee must be a current active or active retired member of Altrusa International Inc.

Fill in the appropriate numbers:

1.  Number of years of membership

2.  Number of years as club president

3.  Number of years as club secretary

4.  Number of years as club treasurer

5. Number of years as other club officer or board member

6. Number of years club committee chair

7. Number of years as club newsletter or yearbook editor

8. Number of bienniums served in non-elective district service (such as secretary or committee chair) 

9.Number of new members sponsored

In 200 words or less, please give a description of nominee's activities and overall contribution to your club and community.

Submitted by: 

Address:  

Telephone: 

E-mail: 

Application must be submitted by April 1, 2009 COB.