CONVENTION REGISTRATION FORM

JUNIOR CONVENTION REGISTRATION - $150.00 ($175.00 After May 15, 2015) - PLEASE PRINT ALL INFORMATION –

Please complete one form per registrant

SPECIAL EVENT PARTICIPATION

_____ Junior/Senior Emerging Leaders Reception (Must be a high school Junior/Senior in the 2015-2016 School Year)

_____ Transferring to Senior Division at Convention (Application must be filled out and signed by your Parish Priest prior to convention)

_____ Fitness Day An organized activity to promote an active and healthy lifestyle for youth.

Name: Last _________________________________________ First _______________________________

Are You a Chaperone?: Yes No (Must be at least 21 years of age)

Status (Check All That Apply): Jr. Knight Jr. Daughter

District or National Officer : _________________________________________ (Title)

Street Address:___________________________________________________ Ste./Apt. #:_____________

City: _______________________________ State: __________________ Zip Code: ___________

Phone No.: (______) ____________________ Age: ________ Grade Level: ______

Email: _____________________________________________________________________________________

Branch/Court Name: ______________________________________ Unit #: __________

T-Shirt Size (Youth Sizes: S, M, L; Adult Sizes: S, M, L, XL, 2X, 3x, 4x): ____________ *Specify Youth or Adult

ACKNOWLEDGEMENT

I have read and agree to the following (Initial Each):

____ Dress Code Requirements ____ Codes of Ethics and Regulations

____ KPC Policy for Minors Traveling with Chaperones

Attendee Signature: ____________________________________________ Date: ____________________

Parent/Legal Guardian (if applicable): _______________________________

REGISTRATION (Continued)

____ Arts & Crafts. Attendees will be grouped and judged based upon their age

____ Photography/Collage. Entries must reflect the convention theme: “One God, One Lord, One Church!”

____ Science Fair Juniors must demonstrate to judges, through written reports, pictures, charts, graphs, and diagrams, that the research was accomplished. Juniors must be present during judging. Will your project require electricity? Yes____ No _____

____ Young Authors. The purpose of this competition is to spark the imagination of writers that will culminate

into a “real life” experience of publishing a book.

____ Speech. Speech must reflect the convention theme: “One God, One Lord, One Church!”

____ Poetry. The poetry must be presented on the Convention Theme: “One God, One Lord, One Church!”

____ Essay. Essay must be written on the Convention Theme: “One God, One Lord, One Church!” ____ Spelling Bee. (Participation limited to Juniors ages 7-14) Each branch and court is allowed one contestant in each age group to compete.

____ 2017 Convention Theme. Our Convention Activity Committee will select our 2017 Junior National Convention

Theme and Symbol design. Submit your suggestion on the competition entry form.

____ Banner Contest. Banner must reflect the Convention Theme: “One God, One Lord, One Church!”

(One entry per Branch or Court to be submitted by the Commander or Counselor)

COMPETITIONS AND CONTESTS REGISTRATION INFORMATION

NOTE: THE DEADLINE FOR ALL COMPETITION ENTRIES IS MAY 15, 2015

Juniors can participate in a maximum of three (3) of the competitions.

To register for a competition, simply place a mark next to the competitions in which you would like to participate and attach a competition entry form to your submission.

See the specific competition entry sheet for complete details and judging criteria.

TENTATIVE SCHEDULE OF EVENTS

Thursday, July 9, 2015

10:00 a.m. – 6:00 p.m. Hospitality Room 11:00 a.m. – 7:00 p.m. Registration 12:00 p.m. – 3:00 p.m. Brown Bag Service Project 12:00 p.m. – 7:00 p.m. Competition Display Set-up 2:00 p.m. – 3:00 p.m. Junior Knight Board Meeting 2:00 p.m. – 3:00 p.m. Junior Daughter Board Meeting 3:00 p.m. – 4:00 p.m. Joint Board Meeting 4:00 p.m. – 5:30 p.m. Junior Daughter Guards Committee 4:00 p.m. – 5:30 p.m. Junior Daughter Steering Committee 4:00 p.m. – 5:30 p.m. Junior Daughter Nomination / Election Committee 4:00 p.m. – 5:30 p.m. Junior Knight Guards Committee 4:00 p.m. – 5:30 p.m. Junior Knight Steering Committee 4:00 p.m. – 5:30 p.m. Junior Knight Nomination / Election Committee 4:00 p.m. – 6:00 p.m. Junior Daughter Credentials 4:00 p.m. – 6:00 p.m. Junior Knight Credentials 6:00 p.m. – 7:30 p.m. Prayer Service/Joint Session 8:00 p.m. – 11:00 p.m. Talent Show

Friday, July 10, 2015

8:00 a.m. – 4:00 p.m. Registration 7:00 a.m. – 8:30 a.m. Junior Knight Credentials 7:00 a.m. – 8:30 a.m. Junior Daughter Credentials 8:00 a.m. – 10:30 a.m. Prayer Service/Joint Session 9:00 a.m. – 2:00 p.m. College Fair/Vocation Fair 10:30 a.m. – 12:30 p.m. Junior Knight Business Session 10:30 a.m. – 12:30 p.m. Junior Daughter Business Session 11:00 a.m. – 12:30 p.m. Competition Judging 12:30 p.m. – 2:00 p.m. Science Fair Judging 1:30 p.m. – 4:30 p.m. Fitness Day 3:00 p.m. – 6:00 p.m. Set-Up Campaign Displays 4:30 p.m. – 6:00 p.m. Poetry Competition 4:30 p.m. – 6:00 p.m. Choir Rehearsal 4:30 p.m. – 6:00 p.m. Committee Meetings 6:00 p.m. – 7:00 p.m. High School Junior/Senior/Emerging Leader

Reception

6:00 p.m. – 7:00 p.m. Dinner (on your own) 7:00 p.m. – 8:30 p.m. Junior Knight Candidate’s Forum 7:00 p.m. – 8:30 p.m. Junior Daughter Candidate’s Forum

TENTATIVE SCHEDULE OF EVENTS (Continued)

Friday, July 10, 2015 - Continued:

8:30 p.m. – 11:00 p.m. Convention Dance 8:30 pm – 11:00 p.m. Movie Night

Saturday, July 11, 2015

7:00 a.m. – 8:00 a.m. Junior Daughters Voting 7:00 a.m. – 8:00 a.m. Junior Knights Voting 7:00 a.m. – 8:30 a.m. Breakfast 8:30 a.m. – 9:30 a.m. Scripture Rosary 9:30 a.m. – 12:00 noon Junior Knight Business Session 9:30 a.m. – 12:00 noon Junior Daughter Business Session 12:00 noon – 1:00 p.m. Lunch (on your own) 1:30 p.m. – 3:30 p.m. 1:30 p.m. – 3:30 p.m. 4:00 p.m. – 5:30 p.m.

USCCB Workshop on Marriage (Gr. 9th- 12th) Black History Workshop (Gr. 2nd- 8th) Choir Practice

4:00 p.m. – 5:30 p.m. Liturgical Dance Practice 4:00 p.m. – 6:30 p.m. Quiz Bowl Competition 4:00 p.m. – 6:30 p.m. Spelling Bee Competitions 4:00 p.m. – 6:30 p.m. Debate Competition 4:00 p.m. – 6:30 p.m. Speech Competitions 6:30 p.m. – 8:00 p.m. Free Time 8:00 p.m. – 11:00 p.m. Convention Awards Banquet

Sunday, July 12, 2015 8:00 a.m. – 10:00 a.m. Convention Mass 10:30 a.m. – 12:30 p.m. Senior Knights Initiation 10:30 a.m. – 12:30 p.m. Senior Ladies Initiation 11:00 a.m. Check-Out

CREDENTIALS FORM

Branch / Court Name: _______________________________________________________ Unit No. _____________

City: __________________________________________________ State: ____________________________

CREDENTIALS - BRANCH / COURT INFORMATION

Branch / Court Name: _______________________________________________________ Unit No. _____________

District: ________________ City: _________________________________________ State: ___________________

Commander / Counselor Name:__________________________________________________________________________

Phone No.: (______) __________________ Alternate Phone No.: (______) _____________________

Email: ______________________________________________________________________________________________

SECTION 1 – JUNIOR GRAND KNIGHT/JUNIOR GRAND LADY

1. _______________________________________________________

2. _______________________________________________________

3. _______________________________________________________

SECTION 2 – DELEGATES

NOTE: Junior Grand Knight and Junior Grand Lady are automatic delegates. Do not list them as your delegates in Section 2.

Each Branch/Court is entitled to three (3) delegates The Junior Deputy Grand Knight /Junior Vice Grand Lady can serve as a delegate IF the Junior Grand Knight/Junior Grand Lady is attending the convention. In order for this to happen, you must place his/her name on the delegate line

1. _______________________________________________________

2. _______________________________________________________

3. _______________________________________________________

SECTION 3 – ALTERNATE DELEGATES

An Alternate delegate will replace the delegate if the delegate is unable to attend the convention business session.

Junior Knights: Send one copy to the National Office (1825 Orleans Avenue, New Orleans 70116), one copy to the Director General (Chris Pichon, 2419 Maywood Run Court, Fresno, Texas, 77545) and retain one copy to be presented to Credentials table.

Junior Daughters: Send one copy to the National Office (1825 Orleans Avenue, New Orleans 70116), one copy to the National Counselor (Katie Guidry-Johnson, 1909 – 11th Street, Lake Charles, LA 70601), and retain one copy to be presented to Credentials table.

(Affix Branch or

Court Seal)

_____________________________________ Signature of Junior Grand Knight/Lady _____________________________________ Signature of Commander/Counselor _____________________________________ Signature of Grand Knight/Lady

PERMISSION

In consideration of the wholesome recreation and/or learning in which my child (whose name appears above) will experience, I do herby agree to allow my child to accompany the Knights of Peter Claver and Ladies Auxiliary Branch/Court No. _____ to the 2015 Junior National Convention in Orlando, Florida.

In consideration of the opportunity for my child to participate in this activity, I agree to release and hold harmless and indemnify the Knights of Peter Claver, Incorporated, its successors, a corporation and their directors and officers from any liability, claims, actions, and causes of action arising out of or relating to any loss, damage, or injury sustained in connection with my child’s participation in this activity.

I hereby grant permission to the organization’s adult leader in charge of this event to obtain medical care from licensed physicians, hospitals, or medical clinics for my child in the event that I cannot be reached.

I am covered for hospitalization and medical care.

________________________________________ Insurance Company Name (Optional) Policy Number

I do not have medical coverage and assume responsibility for the costs of hospitalization and medical care for my son/daughter.

JUNIOR TRAVEL PERMISSION and MEDICAL RELEASE FORM

Name: Last _________________________________________ First _____________________________________

Street Address:______________________________________________________________ Ste./Apt. #:_____________

City: ____________________________________________ State: ___________________ Zip Code: ____________

Phone No.: (______) __________________ Email: ________________________________________________________

Emergency Contact Name: _____________________________________ Phone No.: (______) _____________________

Branch / Court Name: _______________________________________________________ Unit No. _____________

Commander / Counselor Name:__________________________________________________________________________

TRAVEL PERMISSION/

MEDICAL RELEASE

MEDICAL INFORMATION

Please list any other pertinent medical information (allergies, dietary needs, etc): __________________________________

__________________________________________________________________________________________________

Please list any physical limitations: ______________________________________________________________________

__________________________________________________________________________________________________

I understand and accept that I remain fully responsible for any legal responsibility, which may result from any personal actions taken by my child. I also understand that if my child does not conform to established code of behavior, my child may be scheduled to return home before the end of the event, and transportation costs incurred for my child and the chaperone will be my responsibility.

By signing this form, I declare that I am the legal guardian of the minor child listed above and I am authorized to grant such permission.

Printed Name of Parent/Legal Guardian Signature of Parent/Legal Guardian Date

Parent/Legal Guardian Contact Number : (______) __________________

DRESS CODE JUNIOR DAUGHTERS' DRESS CODE JUNIOR KNIGHTS' DRESS CODE

THURSDAY - CASUAL ATTIRE KPC SHIRT IS PERMISSIBLE

(No Shorts or Cut-Offs)

THURSDAY- CASUAL ATTIRE KPC SHIRT IS PERMISSIBLE Note: No facial jewelry of any kind is to be worn during the

convention (i.e. tongue rings, earrings, et cetera). (No Shorts or Cut-Offs)

FRIDAY- MEETING ATTIRE • Dress or skirt (should be fingertip length-no half skirts,

tank dresses, backless dresses, strapless sundresses and no micro- mini skirt or dresses)

• Shoulders, back or midriff should be covered at all times • Pant suit (No shorts or jeans of any kind or color) Capri

pant suits may be worn • Dress shoes (no gym shoes, thongs or flip-flops) • Hosiery

FITNESS ACTIVITY • Jeans, sweat pants, comfortable pants or knee length

shorts • Convention T-Shirt • Sneakers, tennis shoes (no sandals)

CONVENTION DANCE • Jeans, pants (no shorts of any kind) • T-shirts, No Midriff, No tank tops, No Cut-offs • Sneakers, tennis shoes (no sandals or flip flops)

FRIDAY –MEETING ATTIRE • Dress shirt • Necktie • Dress pants (No jeans) • Coat (optional) • Dress shoes (No sneakers or tennis shoes)

FITNESS ACTIVITY • Jeans, sweat pants, or comfortable pants (no shorts of

any kind) • Convention T-Shirt • Sneakers, tennis shoes (no sandals)

CONVENTION DANCE • Jeans, pants (no shorts of any kind) • T-shirts, No Midriff, No tank tops, No cut-offs • Sneakers, tennis shoes (no sandals or flip flops)

SATURDAY- MEETING ATTIRE • Dress or skirt (should be fingertip length-no half skirts,

tank dresses, backless dresses, strapless sundresses and no micro- mini skirt or dresses)

• Shoulders, back or midriff should be covered at all times • Pant suit ( No shorts or jeans of any kind or color) Capri

pant suits may be worn • Dress shoes (no gym shoes, thongs or flip-flops) • Hosiery

SATURDAY- MEETING ATTIRE • Dress shirt • Necktie • Dress pants (No jeans) • Coat (optional) • Dress shoes ( No sneakers or tennis shoes)

BANQUET ATTIRE (FORMAL/SEMI-FORMAL) • Formal, Semi-Formal or Dressy Dress (Shoulders, back, or

midriff should be covered at all times. Splits should not be higher than the top of knee)

• Dress shoes

BANQUET ATTIRE (FORMAL/SEMI-FORMAL) • Shirt and Necktie • Coat and dress pants (No jeans) • Dress Shoes (No tennis shoes)

SUNDAY MASS ATTIRE • White dress, plain (not after five), • White suit or skirt and blouse, • White hat (Kufi) or chapel veil, • Skin tone hosiery (no designer hosiery) • White gloves • One set of small earrings • All accessories MUST BE WHITE

SUNDAY MASS ATTIRE • Black suit, • Black slacks, • White shirt, • Black tie • Dress Shoes (no tennis shoes)

CODE OF ETHICS (RULES AND REGULATIONS) 1. All Juniors, Commanders, Counselors, and chaperones must be pre-registered. There will be no on-site registration. 2. Juniors, Commanders, Counselors, and chaperones must wear convention name badge at all times. 3. All Juniors are expected to attend all Convention functions. All curfews must be followed. All Juniors and their chaperones should be in their room immediately after the close of all evening events. Security will be monitoring the hall and other areas of the hotel. Chaperones are to have room checks and are responsible for all Juniors assigned to them. 4. Chaperones must accompany Juniors at all times. If possible, chaperones should be members of the Knights of Peter Claver and Ladies Auxiliary Senior Division. The Branch/Court should provide adequate chaperones for the entire convention. There should be one (1) chaperone per three (3) Juniors. For example: one to three Juniors will require one chaperone; four to six Juniors will require two chaperones; seven to nine Juniors will require three chaperones; ten to twelve Juniors will require four chaperones; et cetera. The same pattern must be applied to any number over twelve. 5. Each Junior Branch/Court is allowed to send a delegation of four (4) representatives. Junior Grand Knight/Lady and three (3) elected delegates. The Junior Deputy Grand Knight or Junior Vice Grand Lady and alternate delegates should be indicated on credentials and registration forms in the event your elected representatives are unable to attend the Convention. Delegates must be listed on the Credentials Form and Registration Form. 6. Juniors are not allowed to leave the hotel premises, unless accompanied by a Commander, Counselor, chaperones or parent. 7. Alcohol, cigarettes, marijuana, or other illegal drugs are not permitted at the Convention. If a Junior is caught in or around the usage of these drugs, their parents will be called to remove them from the Convention premises. Permission is granted for Juniors taking medication which is noted on the “Travel/Medical Release Form”.

8. Courtesy and politeness will prevail at all times in meetings and workshops. 9. There should be no running, yelling, or playing in the hotel lobby, hotel halls, between floors and elevators. Respect for other hotel guests must be given. 10. Juniors should have a low, respective voice/tone at all times (no loud talking or outbursts) 11. Loud music is not allowed. Headphones and other electronic devices will be allowed, but will not be the responsibility of the hotel or the Knights of Peter Claver, Inc. if lost or stolen. 12. Juniors caught damaging hotel property will have to pay any financial cost(s) assessed by the hotel. 13. Juniors are expected to conduct themselves accordingly at all times in a manner that will be a credit to our organization. Good manners and proper attire will be expected. 14. Respect should be given to all commanders, counselors, chaperones, assistant commanders, assistant counselors, and all senior members of the Order. 15. All adult chaperones are expected to conduct themselves in the proper manner that would display the fine character of our organization. 16. Conduct not adhering to the stated rules of the Convention will be investigated and a decision will be made as to the proper action that will be taken. 17. Swimming will not be permitted at any time during the convention. 18. The Code of Ethics (Rules and Regulations) will be binding on all Delegates, Chaperones, Commanders, Counselors and senior members attending the Convention. 19. Each branch and court will be responsible for making Juniors, chaperones and others aware of the code of ethics (Rules and Regulations)

MEDIA RELEASE FORM

I, (your full name), do

hereby certify that I am the legal guardian/custodian of

(full name of child), a

minor of Junior Branch/Court Number __________.

I am fully qualified and authorized to execute this Parental Media Release. In my aforementioned capacity, I do hereby

consent to the use, portrayal, posting, publishing or otherwise displaying of the above-named minor’s image, likeness,

photograph and/or other depiction on the official Knights of Peter Claver, Inc. website or other print media. The

foregoing consent is given with the understanding that the website and/or published depiction of the said minor shall be

tasteful and in compliance with the law and/or any other applicable regulation. I shall retain the right to revoke this

consent following the execution hereof, upon thirty (30) days written notice to Knights of Peter Claver, Inc.

Knights of Peter Claver, Inc. shall have the exclusive right to website design and/or print media and to the manner

by which the minor’s name and image are displayed on its webpage(s) and/or print media. This Parental Media Release

constitutes a knowing waiver of any right, claim or legal cause of action I or the above-named minor may have arising

from the use, portrayal, posting, publishing or otherwise displaying of the minor’s image, likeness, photograph and/or

other depiction on the Knights of Peter Claver, Inc. website or print media.

PARENTAL MEDIA RELEASE

I have read the above and foregoing Parental Media Release and fully understand the terms thereof:

Printed Name of Parent/Legal Guardian

Signature of Parent/Legal Guardian

Date

Parent/Legal Guardian Contact Number : (______) __________________

KPC CHILD PROTECTION POLICY

I understand that any action inconsistent with the policy listed above, or my failure to take action mandated by the policy and programs may result in disciplinary action, up to and including the termination of my voluntary service. The KPC Child Protection policy may be downloaded from the forms and document area of www.kofpc.org.

By signing this form, I declare that I have received, read, and understand and agree to comply with the following policies in effect for the Knights of Peter Claver, Inc.

Printed Name of Chaperone

Signature of Chaperone

Date

Chaperone Contact Number : (______) __________________

CHILD PROTECTION POLICY CERTIFICATE

Branch / Court Name: _____________________________________________________ Unit No. _________

Commander / Counselor Name:_______________________________________________________________

CHILD PROTECTION CERTIFICATE - BRANCH / COURT INFORMATION

MAKE 2 COPIES FOR EACH CHAPERONE REGISTERED Keep (1) copy and forward (1) copy to the National Office with your registration

COMMANDER/COUNSELOR AND GRAND KNIGHT/LADY CERTIFICATION

(Affix Branch or

Court Seal)

I certify that the above individual has completed arch/diocesan child protection training and background checks in compliance with the National KPC Child Protection Policy.

Signature of Commander/Counselor

Signature of Grand Knight/Lady

CANDIDATE’S PROFILE AND PERMISSION FORM

If you are seeking a National Office, please complete this form, and return it to the National Office, by May 15, 2015. This form will be given to the Election Committee. Since Juniors seeking office are minors, parental permission is required for a Junior to run for an office. All candidates, aspiring for a National office, must have this permission slip on file with the Nominations/Election Committee.

NAME UNIT No. BRANCH/COURT NAME

ADDRESS CITY STATE ZIP

TELEPHONE EMAIL DATE OF BIRTH AGE YEARS AS A JUNIOR

( ) / /

This is to certify that the above candidate is in good financial standing with the branch/court.

Signature of Jr. Grand Knight/Lady Date

Signature of Commander/Counselor Date This is to certify that I give my son/daughter permission to run for a National Office, in the Junior Knights/Junior Daughters Division of the Knights of Peter Claver Ladies Auxiliary. Signature of Parent Date

Any Junior that reaches the age of 19, prior to, on or during the next convention dates of July 6-9, 2017, may not run for an office.

Eligibility Requirements for Junior National Officer Candidates

In order for a member of the Junior Division of the Knights of Peter Claver, Inc. to be eligible to run for a Junior National Office, he or she must meet the following criteria: 1) The candidate must be a member in good standing, financially and otherwise, with the Junior Division of the Knights of Peter Claver, Inc.

2) The candidate must not be older than 17 years of age (see note below). In particular, a candidate, at the time of election to National Office, must be capable of fulfilling his or her full two-year tenure in office, prior to becoming ineligible for membership in the Junior Division.1

3) If elected to Junior National Office, that candidate is not permitted to hold office in a subordinate Junior Branch or a District or State office during his or her tenure in National Office.

(Note): A member of the Junior Division, who has reached the age 19, must transfer to the Senior Division, at the next initiation of new members, into the local Senior Council or Court. Upon initiation into the Senior Division, the member is no longer eligible for membership in the Junior Division.

RESOLUTIONS FORM

Resolutions submitted to the Junior National Convention are to be typed or printed and bear the Branch/Court's Seal. Please state the articles(s), section(s) and the page number(s) of each resolution. Return the form to the National Office by May 15, 2015. WHEREAS BE IT RESOLVED

Form should be mailed to the National Office by May 15, 2015

Signature of Junior Grand Knight/Lady Signature of Junior Financial Secretary Junior Branch/Court Name and Number Signature of Commander/Counselor

(Branch or Court Seal)

Knights of Peter Claver and Ladies Auxiliary Junior Knights and Junior Daughters

Fitness Day 2015 Friday, July 10, 2015 at 1:30 – 4:30 P.M.

Attire: Refer to the Convention Dress Code The purpose of “Fitness Day 2015” is to educate our youth about juvenile obesity and its related illnesses and provide opportunities for our youth to recognize that “fitness” can be fun. Juvenile Obesity is a National concern. In February 2010, First Lady Michelle Obama, also addressed the matter of obesity on the National level stressing the need for our youth to have healthier life style choices with meals and opportunities to exercise daily. What’s fitness day all about? That’s a question you are probably wondering about. This is what you can expect:

• Informational booths will be set up with health and nutrition information.

• Fitness Stations/Areas – The fitness stations will be set up for the youth to have active participation. These stations are designed to cover the 5 main components of physical fitness:

*Muscular Endurance • Strength • Cardio-respiratory endurance • Flexibility • Body Composition These low impact exercise stations are as follows:

• Jump Rope • Double Dutch • Push-ups - With the ability to modify according to participant. • Sit-ups - Different type for each Rotation. • Stretching- Teach a proper technique and an easy quick way to stretch each muscle. • Pilates/ Yoga • Body weighted Squats. • Balance techniques - To help improve balance. • Twister (ages 7-10) • Zumba – exercise to music • Shuttle Run • Cone Drills - Agility • Ball Drills - possibly a weighted ball • Hop- Scotch (ages 7-10) • Line Dancing • Chair Exercises – for those who cannot exercise on the floor • Hula hoop

• Interactive Workshops

Workshop #1 - Topic: Juvenile Diabetes with exercise “Boot Camp” Workshop #2 –Topic: Move it or Lose it for Life

NATIONAL SERVICE PROJECT 2015

I’m ready to hear about more acts of kindness, are you? What better way to start a positive discussion of this topic than by helping the

homeless in the Orlando area with our National Brown Bag Project.

Make a meaningful difference in your community today by participating in this worthwhile cause by decorating bags that will be filled with hygienic items to help the homeless population in the Orlando area. All materials will be available for you to design a special bag to be given to someone in need. The Service Project will be held on Thursday, July 9, 2015 from Noon to 3:00p.m. All units are being asked to collect hygienic items such as soap, shampoo, and toiletries to bring to the convention. Please note that only units who sign-up will be allowed to participate as space is limited.

Create a bag TODAY for someone in need and they will remember it FOREVER!

BRANCH/COURT NAME UNIT No.

COMMANDER/COUNSELOR NAME

TELEPHONE ALTERNATE TELEPHONE EMAIL

( ) ( )

NAME OF JUNIOR AGE NAME OF JUNIOR AGE

1. 11. 2. 12. 3. 13. 4. 14. 5. 15. 6. 16. 7. 17. 8. 18. 9. 19. 10. 20.

Junior Supreme Knight Creighton James Anthony Guillory

National Service Project 2015

Imagine our world without cancer, it's too difficult you might say, But think of no pain or suffering, just enjoying life as we pray.

Imagine all the people, living worry free, Without that internal illness, that no one else can see.

You may say I'm a dreamer, but I'm not the only one, That hopes the world will be cancer-free, so we can live as one.

Make a donation to help in the fight against Cancer. All monies collected will go to the KPC National Cancer Awareness Fund. Branch/Court Checks or money orders are to be submitted to the Hope for a

Cure Booth at the Jr. Convention by 4 p.m. on Friday, July 10, 2015. Each participate will receive a certificate and a ribbon pin for cancer awareness.

Note: Individuals who donate $5.00 or more will receive a Lapel Pin.

“Each of us has been affected by Cancer, so let’s conquer it together.” BRANCH/COURT NAME UNIT No.

COMMANDER/COUNSELOR NAME

TELEPHONE ALTERNATE TELEPHONE EMAIL

( ) ( )

NAME OF JUNIOR AMT NAME OF JUNIOR AMT

1. 11. 2. 12. 3. 13. 4. 14. 5. 15. 6. 16. 7. 17. 8. 18. 9. 19. 10. 20.

Junior Supreme Lady Kyleigh Alanna Chevis National Service Project 2015

I found a penny today just lying on the ground.

But it's not just a penny, this little coin I've found.

Found pennies come from heaven, that's what my Grandpa told me,

He said angels toss them down. Oh, how I love that story!

He said when an angel misses you, they toss a penny down

Sometimes just to cheer you up, make a smile out of your frown.

So don't pass by that penny, when you're feeling blue,

It may be a penny from Heaven that an angel's tossed to you.

Bring your pennies to help in the fight against Sickle Cell Disease. All monies collected will go to the KPC

National Sickle Cell Fund. Branch/Court Checks or money orders are to be submitted to the Pennies from Heaven Booth at the Jr. Convention by 4 p.m. on Friday, July 10, 2015. Each participate will receive a

certificate and a red ribbon pin for sickle cell awareness.

“Together we can break the Sickle Cycle.”

BRANCH/COURT NAME UNIT No.

COMMANDER/COUNSELOR NAME

TELEPHONE ALTERNATE TELEPHONE EMAIL

( ) ( )

NAME OF JUNIOR AMT NAME OF JUNIOR AMT

1. 11.

2. 12.

3. 13.

4. 14.

5. 15.

6. 16.

7. 17.

8. 18.

9. 19.

10. 20.