Allstate .LIFE INSURANCE

The United States Jaycees®

HEALTHY AMERICANFITNESS LEADERS

OF 1989

NOMINATION FORM

.•• -----"" ®

EIGHTH ANNUAL

UNITED STATES JAYCEES®HEALTHY AMERICAN FITNESS LEADERS

AWARDS CONGRESS

Purpose:

Date:

Hotel:

Banquet:

Award Eligibility:

Judging Guidelines:

Judging Process:

Past HAFL Honorees:

Administered by:

Sponsored by:

In Cooperation with:

To recognize 10 individuals who have demonstrated outstanding leadership inthe area of physical fitness

September 23, 1989

The Westin Hotel, Indianapolis, Indiana

The Indiana Roof Ballroom

Men and women (18 years of age and older), professional or volunteer; must beU.S. citizen

Honorees are selected on the basis of their achievements or contributions in anythree of the following areas:

1. Development of new methods in the area of physical fitness and health2. Creation of a nationwide program fostering better physical fitness and

health3. Success in the influence of national attitudes toward better fitness and

health

4. Contribution of voluntary service to their community, state or nationthrough physical fitness and health

5. Successin the field of fitness and health through scientific or technologicalcontributions or in today's education system

6. Demonstration through active participation, leadership in an amateuror professional athletic sport

7. Overcoming a physical hardship or limitation

Copies of all entries are sent to each of the five screening judges, whoindependently select and rank the top 20. The 20 entries with the highest pointtotals (according to ranking) become finalists. Those entries are sent to fivefinalist judges, who independently narrow the selection to 10.

Include President Ronald Reagan, Jack LaLanne, Irv Cross, Jacki Sorensen,Coach John Wooden and Richard Simmons.

The United States Jaycees, P.O. Box 7, Tulsa, OK 74121-0007,918/584-2481

Allstate Life Insurance Company

The President's Council on Physical Fitness and Sports

THE JAYCEE CREED

WE BELIEVE:That faith in God gives meaning and purpose to human life;That the brotherhood of man transcends the sovereignty of nations;That economic justice can best be won by free men through free enterprise;That govermment should be of laws rather than of men;That earth's great treasure lies in human personality;And that service to humanity is the best work of life.

HEAL THY AMERICAN FITNESSLEADERS"

The U.S. Jaycees, with the supp0r! of AllstaleLife Insurance and the President's Council ofPhysi­cal Fimess and Sports, will select the ten HealrhvAmerican Fimess Leaders~' for 1986. The selection ofthese individuals will be based on their contribu­tions ro the fitness and health of themselves andsociety. Ir is the goal of this Awards Congress ro seckout and recognize those who arc:

Heahhy because they participate in physicallyhealthy activities, practice proper dietary habitsand have a sound moral anitude.American, either natural or naturalized, ac­tivelv involved in the benerment of America'sheal ih.Fir because they contribute to their own physi­cal well being as well as that of American society.Leaders who exhibit positive direction rowardthe physical anitude and health of Americathrough groups or informational means.The U.S. Jaycees fecls that America has pro­

duced and always will produce outstanding leaders.\,\Ie feel that leadership in physical fitness is deserv­ing of high recognition. Therefore, Healrhy Ameri­can Fitness Leaders' Awards Congress is held eachSeptember in Washingron, D.C.

WHO IS ELIGIBLE?Men and women, 18 years and older, profes­

sional or volunteer, are eligible to receive theHealthy American Fitness Leaders"'Award. TheU.S. Jaycees is seeking individuals who exemplifythe award they would receive. They must be healrhy,fit, leaders of pt.'Ople, and American citizens.

Winners will be determined based on achieve­ment, or contributions, in at least three categories.

THE JUDGING CATEGORIES OFHEALTHY AMERICAN FITNESSLEADERSCOOJ

I. The development of a new method in the area ofphysical fitness and healrh.

2. Overcoming a physical hardship or limitation.3. Crealion of a nationwide program fostering bet­

ter physical fitness and health.4. Success in the influence of national anirudes

towards bener fitness and health.;. Contribution of voluntary service to their com­

munity, state or nation through physical fitnessand health.

6. Success in the field of fitness and health throughscientific or technological contributions or inroday's education system.

7. Has demonstrated, through active panicipation,leadership in an amateur or professional athleticsport.Other contributions ro fitness and health will be

considered at the discretion of the judges.

RULES GOVERNINGNOMINATION

1. The nominees may be male or female, 18 yearsor older.

2. The nominees must be citizens of the UnitedStates of America, native or naturalized, ormust have applied for citizenship by January I,1986.

3. The nominees must excel in at least three (3)categories.

4. The nominees must be of good moral and relig­ious character.

;. All information must be contained on the pagesof this form.

6. The nominees must sign the nomination formpersonally. With their signature, they will anestthat all facts contained on the form arc true,give permission for publication of the facts andwill commit, barring extreme circumstances,to anend the Healthv American Fitness Lead­ers·g· Awards Congress, September I I- I4, 1986.

7. Nomination forms are ro be maIled to: HealrhvAmerican Fitness Leaders,'"'P.O.Box 7, Tulsa,OK 74121-0007.

8. Submit a good quality 8"x 10" black and white,head-and-shoulders phoro with nominationform.

9. All entries must be postmarked no later thanApril I, 1986.

____________________________ Please: type using bhiCk rihbon _

Citizenship Date of Citizenship _

Birthdate _

Placc _

:\'ominec's Full :\'ame Prescnt Age _

Addre" Cit)" S[ate Zip Home Phone _

Occupation or Profession Position or Title _

Bu~incss AJJrc ..-ss City Statc Zip _

Business Business Phone _

,\Iari[al Status (spousc's name) Children: (1S:ame, Age) _

Schools attended (Degrl'Cs, Academic Honors, Etc.) _

Ci\"jc, Fraternal, Religious Organizations and Affiliations (e.g., American Red Cross, Director, 19(4), -----------------------------

Puhlished \X'ork _

Answer each of the following questions using as much or as liule space foreach one as desired, within the alloned pages. Indicate by number where eachanswer begins.No attachments of any kind to nomination blank are allowed.Single spaced, typcwriuen answers arc preferred with a double space betweenparagraphs. Be as factual as possible.

DIRECTIONSI. Outline (describe) the career or present al:~ivity (scholastic, volunteer, etc.) of

the nominee, including some background, and the scope of his or her workor activity.

2. Describe the nominee's exceptional achievement or contribution to fitnessand health in his or her chosen field or volunteer service to an organization,community, state or the nation using three of the above JUDGING CATE­GORIES.

3. List awards and honors received.

4. Describe the nominee's greatest contributions to society.DEADLINE: Postmarked not later than April 1, 1986

Nominee must sign blank on back page

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DEADLINE: Postmarked not later than April 1, 1986

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Nominee must sign blank on back page

DEADLINE: Postmarked not later than April I, 1986

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Nominee must sign blank on back page

DEADLINE: Postmarked no later than April I, 1989.

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Mail Nomination Blank to: Healthy American Fitness Leaders®, P.O. Box 7, Tulsa, Oklahoma 74121-0007FOR NOMINATOR:Summarize the nominee's most outstanding humanitarian efforts, howhe or sheexemplified the lineof theJayceeCreed that states-"That service to humanity is the best work of life."

FOR THE NOMINATOR:Summarize within this space the reason why you (the nominator) believe that your nominee should be selected one of theHealthy American Fitness Leaders" for 1989.

Nominator's Name Signature _

Address City State Zip Bus. Phone _

Occupation, Businessor Jaycee Chapter Name:

FOR THE NOMINEE: I attest to all the facts contained on this fonn as true and give pennission for the facts to be used forpublication. With agreement to accept a Healthy American Fitness Leaders Award, I understand that, barring extremecircumstances, the nominee is required to be present at the HAFL congress, no earlier than September 22, 1989, and no later than

12:00 noon on September 23,1989. In the event circumstances prevent attendance, I must present the conditions to The United StatesJaycees president for his decision on my continued eligibility for an award. The winner's expense (travel within the continental limitsofthe U.S., lodging, meals, and fonnal wear) are paid in full for the awards congress trip. The ten honorees will be notified of theirselection no later than July 31,1989. The selection of all honorees must be kept confidential by them until The United States Jayceesmakes the fonnal announcement of the selections.

Signature of Nominee

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