Lions MD201 Leo of the Year Information and Entry Form
MD201 Leo of the Year Quest
Aims of the Quest
1. To develop and encourage the qualities of Leadership, Experience and Opportunity
2. To select a fine ambassador for the Leos of Australia and PNG (Multiple District 201)
Qualifications for entry
The entrant must be a financial member of a Leo Club in good standing, and should:
1. Show a genuine commitment to the ideals of community service
2. Be actively involved in the activities of his/her Leo Club and the wider community
3. Demonstrate a high level of leadership skills within Leos and the community
4. Contribute to the development and growth of the Leo Club Program
5. Have a knowledge and appreciation of the Leo Program and Lions International
6. Have a knowledge and appreciation of Australian/PNG and world affairs
7. Have good communication skills and personal presentation
Judging procedures
Leos wishing to enter the competition must complete the Entry Form and submit it to the District Leo Chairman
who will arrange the first level of judging. Please check with your district Chairman for the closing date, as it
will vary between Districts.
The District winners will proceed to State judging and State winners progress to national finals at the MD Lions
Convention (usually held in early May). Where possible, there should be four clear weeks between the various
levels of judging. Entry Forms for Multiple District judging must be submitted to the MD Leo Chairman by 1
April each year.
Judging consists of a 20-30 minute interview with a panel of Lions and community members, plus delivery of a
5 minute speech to an audience of Lions and interested community members.
Judging panel
For District and State judging, there will be three judges. The panel will be of mixed gender and consist of two
members of the Lions family and one community member.
At the National final, there will be five judges. The panel will be of mixed gender and consist of four members
of the Lions family (including one Leo) and a prominent member of the community.
Lions MD201 Leo of the Year Information and Entry Form
Judging criteria
Contestants will be judged on their Entry Form, Interview and Public Speaking. Points will be allocated as
follows:
Community service involvement
25
Leadership & contribution to development of Leos
25
Knowledge of Leos and Lions
10
Knowledge of local and world affairs
10
Impact during interview
10
Public speaking
20
TOTAL
100
Prize – National winner
The Multiple District Leo of the Year is funded up to $1500 to travel within Australia to promote the Leo
program OR if the winner is under 18 years of age, he/she will join the Lions Youth of the Year winners at an
International Youth Camp in New Zealand in December/January. The winner will also receive up to $2000 for
personal study or travel, as negotiated with the MD Leo Chairman.
The MD Leo of the Year winner will be required to promote the Leo program and the Leo of the Year Quest
throughout the Multiple District, and attend the following MD Convention to assist the MD Leo Committee
with the LOTY judging and other Leo activities. The MD Leo of the Year will also be required to submit a report
on his/her experiences, opportunities and points of view as a result of holding this position for 12 months.
Best Public Speaker
At the Multiple District final, there is a Public Speaking prize of $500 for the entrant who gains the highest
score in the Public Speaking section of the judging.
Prizes – National finalists
All State winners who compete in the National Final will be funded to attend a Lions International Youth Camp
within Australia in the year following the National Final.
Prizes – District and State judging
Prizes at District and State judging are at the discretion of the individual Districts/States. They may or may not
include a Public Speaking prize.
Privacy
Lions Australia respects your privacy. Information collected in this form and throughout the Leo of the
Year Quest will be used in accordance with the Lions Australia Privacy Policy, which can be found at
http://lionsclubs.org.au/wp-content/uploads/2014/03/2014-Privacy-Policy-v05032014.pdf
Further Information
See the Leo section of the Lions Australia website www.lionsclubs.org.au/leos or contact your local
Leo Club Chairman, State Leo Coordinator or MD Leo Chairman.
Lions MD201 Leo of the Year Information and Entry Form
Leo of the Year Entry Form
Please type your responses into this form, then print it and have it signed by appropriate people as
directed on the form. It should then be submitted to your Leo Advisor or District Leo Chairman in
preparation for the first level of judging. Please ask them for the due date for each level of judging.
Surname _______________________________ Given name __________________________
Date of birth ____________________________ Gender
Male / Female
Address ______________________________________________________________________
_____________________________________________________________________________
Telephone (home) ________________________ Telephone (mobile) ____________________
Email address _________________________________________________________________
Leo Club ________________________________ Member of Leos since _________________
Sponsoring Lions club __________________________________________________________
Terms and conditions
1. I am a member of a Leo Club in good standing.
2. I agree to abide by the rules and procedures of the Leo of the Year program.
3. I accept that I will be contacted by the Lion/s organising the Quest to arrange the interview
and public speaking judging.
4. I agree to attend all judging levels as required, including those which require me to travel. I
understand that reasonable travel and accommodation expenses will be reimbursed by Lions.
5. I agree to cooperate with the Lions organisation and follow all reasonable requests of me in
my role as a representative of the Leos of Australia.
6. I agree to my name and/or photograph being used in media reports relating to the Leo of the
Year Quest, and accept that these may be published in the media, the Australian Lion
magazine and/or any Lions website.
7. I submit this application on the basis that the information provided is correct, and the views
expressed are mine.
Signature of entrant
In signing this agreement, I consent to the Terms and Conditions of entry as listed above.
Signed ____________________________________
Date ___________________________
Signature of parent/guardian (required if entrant is under 18 years of age)
In signing this agreement, I/we consent to the Terms and Condition of entry as listed above.
Name ____________________________________
Relationship ____________________________
Signed ____________________________________
Date __________________________________
Telephone (home) __________________________
Telephone (mobile) ______________________
Email address _______________________________________________________________________
Lions MD201 Leo of the Year Information and Entry Form
Contestant information
1. Leo membership
Name of Leo Club _________________________________________ District ______________
Date joined ___________________________
Have you changed Leo clubs?
Yes/No
Previous Leo Club _________________________ Dates of membership ___________________
2. Leadership
List the positions you have held in your Leo club/s.
Position
Year
Major initiatives
List the positions you have held at District, State or Multiple District level.
Position
Year
Major initiatives
Explain how you have demonstrated your leadership ability in Leos.
Lions MD201 Leo of the Year Information and Entry Form
3. Leo development
List examples of your contribution to the development and growth of the Leo club program (e.g.
publicity and promotion of Leos, new members invited, new clubs formed)
4. Service record
List the major service activities of your current Leo club in the past year, and indicate your role in
each activity.
Service Activity
Date
My involvement
Lions MD201 Leo of the Year Information and Entry Form
Give a brief description of the project that you have found must fulfilling.
5. Achievements and impact
What do you see as your major achievements in Leos? How have you benefited from Leo
membership?
6. Education & employment
Lions MD201 Leo of the Year Information and Entry Form
Education level attained _______________________________
Year __________
Future education goals ____________________________________________________
Current employment ____________________________________
Full time / part time
Previous employment ___________________________________
Full time / part time
7. Activities outside Leos
Other community involvement
Leadership in other organisations (e.g. school, sporting teams, clubs)
Interests and hobbies
8. Knowledge of Lions and Leos
In your own words, please provide a brief outline of the formation and purposes of Lions and Leo
Clubs and discuss the impact of Lions and Leos’ service projects in your local community and
around the world.
(Limit your response to 500 words and attach it as Item 8 to your entry form)
Lions MD201 Leo of the Year Information and Entry Form
9. Photo
Please attach a high quality photo of yourself (head & shoulders only). If submitting your form
electronically, please send the photo as a separate attachment in jpg format, approximately 2mb
in size.
Please note that your photograph may be used in program brochures, media coverage and on the
Lions/Leos website and Facebook page.
10. Speech
Please prepare a 5-minute speech on a topic of your own choice. It is suggested that you choose a
topic that reveals something of your own life experiences, or something you are passionate about.
This speech will be presented to an audience of Lions and interested guests at each level of
judging for which you qualify.
Endorsements
I/we endorse this entry in the Leo of the Year Quest for 2016, and will support this entrant to
participate in all levels of judging as eligible (including financial support where necessary).
I consent to being named in any media publicity that is generated by the Quest.
1. Sponsoring Lions Club – for District LOTY judging
Name _______________________________________
Leo Club Advisor / Lions Club President
Signature _____________________________________
Date ____________________
2. District Leo Chairman – for State judging
Name _______________________________________
District 201 _____
Signature _____________________________________
Date _____________________
3. State Leo Coordinator - for Multiple District judging – submit by 1 April
Name _______________________________________
State _____________________
Signature _____________________________________
Date _____________________