Award Certification Document

AWARD

CERTIFICATION DOCUMENT

(CLUB NUMBER)

, PRESIDENT

(PRESIDENT OF CLUB)

OPTIMIST CLUB OF

(NAME OF CLUB)

DO HEREBY CERTIFY THAT OUR CLUB HONORED

WITH A

(NAME OF CLUB MEMBER OR LOCAL COMMUNITY INDIVIDUAL)

(TYPE OF HONOR OR AWARD)

(DATE OF PRESENTATION)

SIGNED

(CLUB PRESIDENT)

(DATE)

If your Club is located in Canada, please mail this completed form to the Canadian Service Centre,

Optimist International, 5205, boul. Metropolitain Est, bureau 200, Montreal, QC H1R 1Z7.

Attn: Beatrice Rossignol or email

If your Club is located in the USA or Caribbean, please mail this completed form to

Optimist International, 4494 Lindell Blvd St. Louis, MO 63108.

Attn: Jackie Moore or email | Fax # 314-371-6006

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