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Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

March 6-8, 2009


Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

Louisiana-Mississippi-West Tennessee Circle K District would like to invite you to celebrate the 50th Annual District Convention with the theme Lights, Camera, Action! This packet contains the forms necessary to register and attend the convention, along with additional information to share with those individuals attending the convention. Contest forms will be provided by the District Board.

The Convention Registration Packet includes: •

CONVENTION REGISTRATION FORM - The official form to register all clubs and individuals for the convention REQUIRED: Deadline: 2/13/2009

HOTEL ROOM RESERVATION FORM – The official form to make room reservations at the convention hotel REQUIRED: Deadline: 2/13/2009

CERTIFICATE OF ELECTION OF DELEGATES AND ALTERNATES – Each club allowed two (2) delegates to represent the club. Elect your delegates early! REQUIRED: Deadline: 2/13/2009

CERTIFICATION OF SERGEANT-AT-ARMS AND ALTERNATES – Clubs must assist with security during the convention. Select your Sergeant at Arms now! REQUIRED: Deadline: 2/13/2009

KIWANIS RESPONSIBILITY FORM – Each club’s sponsoring Kiwanis Club must acknowledge that their Circle K Club will be attending the convention and accept responsibility for the club REQUIRED: Deadline: 2/13/2009

DISTRICT CONVENTION CODE OF CONDUCT – Lays out the standard operating rules for members to follow while attending the convention.

MEDICAL INFORMATION & CODE OF CONDUCT AGREEMENT FORM – Each member must provide basic information in case of an emergency and agree to adhere to the Convention Rules REQUIRED FROM EACH REGISTRANT – NO EXCUSES!: Deadline: 2/13/2009

PROGRAM-AT-A-GLANCE – Share with your members so they know what will be happening at the convention.

PACKING LIST FOR CONVENTION!! – Share with your member so they know what to bring to the convention.


Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

Please TYPE or PRINT NEATLY. Circle K Club of:

MPORTANT: Read carefully Address: City:

• DEADLINE: Postmarked by State: Zip: FEBRUARY 13, 2009 • DEADLINE TO RESERVE HOTEL ROOM: Postmarked/Faxed by FEBRUARY 13, President’s Name: President’s Phone Number:

• • • • •

Email Address:

2009 - Reservations made after this date are subject to availability and may not be at the convention rate! The Convention Registration Fee is $110.00 ($135.00 if postmarked after February 13th) per person & must accompany this form, along with the Club Delegate Form, the Sergeant-At-Arms Form, the Kiwanis Responsibility Form, and a Medical Information Form for each Registrant listed below. One club per form (you may make copies if extra space needed). Make check payable to: CIRCLE K DISTRICT CONVENTION All enclosed registration forms must be mailed by FEBRUARY 13, 2009. NO LIMIT on Members/Advisors attending. Make adequate copies of both sides of this form to distribute to all members attending the District Convention.

LIST ALL MEMBERS ATTENDING ON THE FOLLOWING PAGE

NAME OF ATTENDEE

Shirt Size

Please Indicate: “OFFICE HELD", "MEMBER" "ADVISOR" or "KIWANIAN"


Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.

Number from club registered:

2.13.09

Total convention registration fees, if postmarked...

Fee per member: TOTAL REGISTRATION FEES ENCLOSED:

AFTER 2.13.09

_______

__________ X $110.00

X $135.00

$_________

$_________

CIRCLE K DISTRICT CONVENTION Circle K District Office P.O. Box 14026 Baton Rouge, LA 70898-4026 This form MUST BE MAILED OR FAXED DIRECTLY to the convention hotel: COUNTRY INN & SUITES ● 111 BROADWAY STREET ● Natchez, MS 39120 RESERVATIONS: (866)-488-0898 US Toll Free Telephone: (601) 446-9994 FAX: (601) 446-9957 E-MAIL: patrica.lozon@countryinns.com

MAKE CHECK PAYABLE TO: And Mail to:


Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

Use one (1) of these forms for each room reservation being made. Photocopy form if additional copies are needed.

ROOM RESERVATION REQUEST FOR: Circle K Club of Member/Advisor making reservation: Mailing Address: Daytime Phone Number: (________)

ACCOMMODATIONS NEEDED: (no more than 4 allowed in each room!) Room Rate: $109.99 plus 10% sales tax & $8.95 occupancy fees = Total: $129.94 per room, per night (includes free hot breakfast and unlimited wireless access and phone calls.)  SINGLE: 1 or 2 persons  DOUBLE/DOUBLE: 2, 3, or 4 persons  KING/QUEEN: 1 or 2 persons ARRIVAL DATE: 3/_____/09 (check-in time: 3:00 pm) DEPARTURE DATE: 3/_____/09 (check out time: 11:00 am) ROOMMATES:

1.

Club:

2.

Club:

3.

Club:

4. _______________________________________ Club: IMPORTANT NOTE: A one-night deposit guarantee (paid with a cashier’s check, money order or a major credit card) is required for each room. Send payment with this Room Reservation Form. Cancellations must be made 72 hours prior to arrival, or you lose all of your deposits - NO EXCEPTIONS!

DEPOSIT ENCLOSED:  CHECK NAME AS IT APPEARS ON CARD: CREDIT CARD:

VISA

CREDIT CARD 

MASTERCARD

AMERICAN EXPRESS

CARD NUMBER: Mail this form directly to: OR Fax to:

EXP. DATE: COUNTRY INN & SUITES 111BROADWAY ST. NATCHEZ, MS 39120 Fax: (601) 446-9957

CERTIFICATE OF ELECTION OF DELEGATES AND ALTERNATES This is to certify that the following members of the Circle K Club of

DEADLINE: 2.13.2009


Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

City:

State:

Zip:

________

_ _are duly elected as the delegates and alternates of this club:

DELEGATES 1. NAME: _____________________________________________ OFFICE: __________________ ADDRESS: _____________________________________________________________________ 2. NAME: _____________________________________________ OFFICE: __________________ ADDRESS: _____________________________________________________________________

ALTERNATES 1. NAME: _____________________________________________ OFFICE: __________________ ADDRESS: _____________________________________________________________________ 2. NAME: _____________________________________________ OFFICE: __________________ ADDRESS: _____________________________________________________________________ Signed: ______________________________________________, President Date: ______________ Signed: ______________________________________________, Secretary Date: ______________ Each chartered club in good standing (one that has paid BOTH District and International Dues) shall be entitled to two (2) delegates to the convention. These delegates should be elected prior to the convention. Each delegate shall be entitled to cast one vote, and in his/her absence, the duly certified alternate may cast one vote. THERE SHALL BE NO VOTING BY PROXY.

Return this form by FEBRUARY 13, 2009 to: CIRCLE K DISTRICT OFFICE P.O. BOX 14026 BATON ROUGE, LA 70898-4026

CERTIFICATION OF


Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

SERGEANT-AT-ARMS AND ALTERNATES This is to certify that the following members of the Circle K Club of

City:

State:

Zip:

_are duly elected as the delegates and alternates of this club:

SERGEANT-AT-ARMS 1. NAME: _________________________________________ OFFICE: ______________________ ADDRESS: _____________________________________________________________________ 2. NAME: _________________________________________ OFFICE: ______________________ ADDRESS: _____________________________________________________________________

ALTERNATES 1. NAME: _________________________________________ OFFICE: ______________________ ADDRESS: _____________________________________________________________________ 2. NAME: _________________________________________ OFFICE: ______________________ ADDRESS: _____________________________________________________________________

Signed: ___________________________________________, President Date: _________________ Signed: ___________________________________________, Secretary Date: _________________

Return this form by FEBRUARY 13, 2009 to: CIRCLE K DISTRICT OFFICE P.O. BOX 14026 BATON ROUGE, LA 70898-4026

This is to certify that the Kiwanis Club of


Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

_________________________________________________________________________________ Is aware that their sponsored Circle K Club of _________________________________________________________________________________ will be attending the 2008-2009 Louisiana-Mississippi-West Tennessee Circle K District Convention in Natchez, Miss. The above Kiwanis Club does approve of members of the Circle K Club attending the District Convention and that should any damage be incurred by the Circle K Club, the Kiwanis Club will assist the Circle K District Board in collecting the cost of the damages from the Circle K Club or members of that club that were held responsible. THIS FORM IS TO INDICATE THAT THE KIWANIS CLUB IS NOT BEING HELD RESPONSIBLE FOR DAMAGES, ONLY THAT THE KIWANIS CLUB WOULD ASSIST IN COLLECTING FOR DAMAGES, IF THEY OCCUR. This form has become necessary because of requirements being placed upon youth groups having conventions in hotels. This was not because of any problems or damages caused by Circle K Clubs. Signed: _______________________________________, President, Circle K Club Signed: _______________________________________, Faculty Advisor, Circle K Club Signed: _______________________________________, President, Sponsoring Kiwanis Club Signed: _______________________________________, Secretary, Sponsoring Kiwanis Club

Return this form by FEBRUARY 13, 2009 to: CIRCLE K DISTRICT OFFICE P.O. BOX 14026BATON ROUGE, LA 70898-4026


Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

The LaMissTenn District Board urges everyone to enjoy the convention fully. To insure proper behavior, the Board has adopted the following rules for all attendees to assure the safety, comfort, and pleasure of everyone. 1. In accordance with the Circle K International Policy on Alcohol at official functions, NO ALCOHOLIC BEVERAGES WILL BE ALLOWED AT THE DISTRICT CONVENTION. 2. Everyone present at the Convention must be officially registered with the Convention and must wear your nametag to enter Convention functions. 3. Sergeant-At-Arms will be on duty and have the authority to control behavior. Depending on the severity of the infraction, the responsible party might be asked to leave the Convention. Your home club and sponsoring Kiwanis Club will be notified of your conduct. 4. The people registered in the rooms, along with the clubs in which they are members of, will be held responsible for any damage done to the hotel. 5. Professional business attire (coats and ties for men, and dresses for ladies) is required for the SATURDAY PRESIDENTS' BANQUET & BALL, and the HOUSE OF DELEGATES. 6. Business casual attire (slacks and collared shirts for men, and appropriate attire ladies NO jeans! NO shorts!) is required for the activities on Saturday: KIWANIS FAMILY SESSION, WORKSHOPS, and CAUCUSES, and for the SUNDAY FAREWELL BANQUET. 7. Casual attire is appropriate for the OPENING SESSION (preferably club T-shirts) and the KIWANIS FAMILY LUNCH on Saturday afternoon. 8. No posters or any other materials may be attached to any surface of the hotel. Sergeant-at-Arms will remove any material and notify the candidate. Candidates will be responsible for notifying their people not to attach literature to hotel surfaces. 9. All voting delegates must be properly certified in order to enter the House of Delegates. Delegates must be on time for the House of Delegates on Saturday afternoon.

NOTE: Agreement for Code of Conduct is on the Medical Information Form. Every Circle Member attending this District Convention is required to sign that they have read, understand, and agree to abide by the Convention Code of Conduct.


Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

NOTE: Every Circle K Member attending this District Convention is required to properly complete a Medical Information Form and to sign that they have read, understand, and agree to abide by the Convention Code of Conduct. The completed forms must be returned with the club’s Convention Registration Package no later than February 13 th. Name: Birthdate:

Social Security Number:

Emergency Contact:

Telephone Number: (

)

Family Doctor:

Telephone Number: (

)

Medical Insurance Carrier: Policy Number:

Group Number:

Do you normally carry a Medical Insurance Card on your possession? Are you taking any medications?

If so, which one(s):

Are you allergic to any medications?

If yes, which one(s)?

Any medical history that you feel is important to know? Do you suffer from any type of seizures? To District Administrator: {1} The Medical Information above is accurate, to the best of my knowledge. {2} I have received a copy of the CONVENTION CODE OF CONDUCT, read it, and understand that compliance with these rules is required at all times during the convention. I also understand that a violation of any of these rules may result in a Circle K member being sent home at their own expense.

Signature

Date


Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

PROGRAM-AT-A-GLANCE 50th Annual Convention Friday, March 6, 2009 4:00 PM - 7:00 PM 7:00 PM – 8:00 PM 8:00 PM – 8:30 PM 8:30 PM – 9:30 PM 10:00 PM - 12:00 AM

Registration Opening Session (Club T-shirts) Candidates Meeting Sergeant-At-Arms Meeting District-wide Caucus Evening Activities

Saturday, March 7, 2009 6:30 AM – 8:45 AM 8:30 AM – 9:00 AM 9:00 AM – 10:00 AM 10:15 AM – 12: 30PM 12:45 PM – 2:45 PM 3:00 PM – 5:00 PM 5:00 pm – 6:00PM 6:00 PM – 7:30 PM 8:00 PM – 9:30 PM 10:00 PM – 12:00 AM

Breakfast on your own Late Registration Kiwanis Family Session Workshops Divisional Caucuses Service Project Kiwanis Family Lunch Pie Auction Workshops Divisional Caucuses Service Project Free Time House of Delegates Presidents’ Awards Banquet Presidents’ Ball

Sunday, March 8, 2009 6:30 AM – 9:15 AM 8:30 AM – 9:15 AM 9:30 AM – 11:30 AM 11:30 AM – 12:30 PM

Breakfast on your own Joint Meeting of the 2008-09 and the 2009-2010 District Boards & Club Presidents Governor's Farewell Session 2008-09 District Board Meeting


Louisiana-Mississippi-West Tennessee District Circle K International 50th Annual District Convention

PACKING LIST FOR CONVENTION!! • Paper, pen, pencil, etc. • Nice dress clothes. Guys: coat & ties (enough for three times) Gals: dresses, skirts/shirts (enough for three times) • Spending money (in case you do not get enough to eat, etc.)! • Extra snacks & such in case you get the late night munchies! • Money, so you can bid on a pie to get your favorite district officer! • Shampoo, soap, extra towel (just in case) so you can stay clean during the weekend!!! • A good attitude, ideas, concerns, great caucus questions!!! • Club spirit and enthusiasm. (Club T-shirts for opening session, and cheers for roll call at this time!!) • Have a Talent ready for Saturday Night’s Talent Show! • Two Delegates for the House of Delegates & Two Sergeant-atArms! • Your clubs awards packet!! (Completed!)

CONVENTION REGISTRATION PACKET  

• PROGRAM­AT­A­GLANCE – Share with your members so they know what will be happening  at the convention. • PACKING LIST FOR CONVENTION!! – S...

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