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AVENUES OF SERVICE CITATION

FOR INDIVIDUAL ROTARIANS
NOMINATION FORM
PURPOSE
Recognizing that the strength of the Rotary ideal is founded on the service carried out by club members
worldwide, this citation program provides a means for Rotary clubs to personally recognize a member of
the club for outstanding efforts in the five Avenues of Service. The citation commends the service carried
out by an individual Rotarian in the club, thereby reinforcing the importance which Rotary places on the
personal involvement of each club member in Rotary service activities.

SELECTION PROCESS
The method of selection is to be determined by the club president. Club presidents may wish to appoint a
special committee to select a nominee, or may ask their board of directors to carry out this responsibility.
Club nominations are to be submitted by the club president to Rotary International, with an information
copy to the district governor.

ELIGIBILITY
The nominee must have consistently demonstrated support of the Object of Rotary through
participation in service activities in each of the five Avenues of Service: Club, Vocational, Community,
International, and Youth.
An individual may only receive this award once.
The nominee must be an active Rotarian in good standing.
Rotarians who are ineligible:
Current club presidents
Current, incoming, and immediate past district governors
Current, incoming, and past RI directors
Only one nominee is eligible per club per Rotary year.

NOMINATION (Please type or print clearly)

District Rotary Club of Club ID

Name of nominee
First Last Member ID

Name of club president

First Last Member ID

Telephone Email

Signature of club president (required)

Shipping address
Name Address 1 Address 2

City State/Province Country Postal code

To ensure prompt delivery, we no longer accept P.O. boxes. Please provide a physical address.

A certificate will be sent to the club president for the recipient. Please allow four weeks to process the
nomination to accommodate peak demand. Nominations are accepted at RI World Headquarters during
the Rotary year on a rolling basis.
Name of nominee

In the space provided, please outline how this nominee was personally involved in carrying out the five
Avenues of Service.

Club Service

Vocational Service

Community Service

International Service

Youth Service

Please return to: Programs and Presidential Initiatives (PD210), Rotary International, One Rotary Center,
1560 Sherman Avenue, Evanston, IL 60201-3698 USA.
Fax: +1-847-556-2179 Email: riawards@rotary.org