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Legacy of the Year (Legacy) Award
District Nomination Form

2024 - 2025

NOTE: This Electronic Form is for Exchange Clubs to submit their Local Club Winners Only.

Deadline for submission is April 15th

ONE APPLICATION PER FINALIST

Incomplete submissions will not be considered.

Submitter's Name(Required)

Exchange Club Information

Exchange Club President Name(Required)

Legacy Exchange Member Information

Legacy Exchange Club Member Name(Required)
Who is the Individual sponsoring this Student that is a parent/grandparent/great grandparent?
Please name the Exchange Club the Legacy Club Member has a membership.
Legacy Exchange Club Member(Required)
Is the Legacy Exchange Club Member current and active in the Club?

Student Information

Student Name(Required)
MM slash DD slash YYYY
Gender(Required)

Upload your Application

Accepted file types: pdf, Max. file size: 25 MB.

Certification Submission

Application Certification(Required)
I certify that this candidate has been chosen and approved by the board of directors of this Exchange Club. This selection adheres strictly to the rules and regulations of the Legacy Award program as outlined by The National Exchange Club.
National Travel Certification(Required)
I verify that if this nominee is designated a winner, they will be able to accept the award in person, during the scheduled event, and are available and willing to attend the Convention from Wednesday through Sunday.
Sponsoring Club Travel Certification(Required)
If the student is designated a winner, the above named Exchange Club Sponsor from the will be responsible for the nominee’s attendance at Exchange’s District Convention.
This field is for validation purposes and should be left unchanged.
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