western states district junior virtual conference …€¦ · 1. all juniors, commanders,...
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WESTERN STATES DISTRICT JUNIOR VIRTUAL CONFERENCE CHECKLIST
To be completed by: Parents and Guardians
Media Release Parental Consent Form (page 2)
Code of Ethics (Rules and Regulations) (page 3)
Dress Code (page 4)- Zoom Appropriate
Senior High School Information Form for Graduating Senior (page 5)
To be completed by: Commander and Counselor
Junior and Adults Registration Form (page 6)
Committee Sign-Up Worksheet (page 7)
Resolution Form (page 8)
Souvenir Booklet Advertisement and Patrons Form (page 9)
Family Claver Activities Form (page 10)
Community Service Projects Form (page 11)
Credential Form (page 12)
To be completed by: All Adults Attending Event
Media Release Form Virtual Conference (page 2)
Code of Ethics (Rules and Regulations) (page 3)
Dress Code (page 4)
Junior and Adults Registration Form (page 6)
ALL PARTICIPANTS WILL BE CHARGED A $10.00 REGISTRATION FEE
Please make Unit’s check, money order, or cashier’s check payable to: WSD Joint Junior Account, and forward payment with Registration Packet (all required signed forms and documents unless otherwise stated on the form; i.e.: Credentials) to:
Junior Daughters: Lady Karen Pinson Junior Knights: Brother Leroy Titus
WSDC Financial Secretary WSDC Financial Secretary
809 West 169th Place 13282 Briarwood Street
Gardena, California 90247 Cerritos, California 90703
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WESTERN STATES DISTRICT JUNIOR VIRTUAL CONFERENCE MEDIA RELEASE PARENTAL CONSENT FORM
I, (your full name), do hereby certify that I am the
parent/legal guardian/custodian of (full name of child), a minor. I
am fully qualified and authorized to execute this Parental Consent Form. In my aforementioned
capacity, I do hereby consent to the photographing and videotaping, as well as the use,
portrayal, posting, publishing, web page, ZOOM meeting or otherwise the above named minor’s
image, likeness, photograph, video footage and/or other depiction or in conjunction with the
Western States District Junior Conference. The foregoing consent is given with the
understanding that the published depiction of the said minor shall be tasteful and in
compliance with the law and/or other applicable regulation. I shall retain the right to revoke
this consent following the execution hereof, upon 30 days written notice to the Western States
District Junior Conference.
The Knights of Peter Claver, Inc. and Ladies Auxiliary the Western States District Junior
Conference shall have the exclusive right to the design and to the manner by which the minor’s
name and/or image shall be displayed in the final publication. The Parental Consent Form
constitutes a knowing waiver of any right, claim or legal cause of action that 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, video footage and/or other depiction at or in
conjunction with the Western States District Junior Division Junior Conference.
I HAVE READ THE ABOVE AND FOREGOING PARENTAL CONSENT FORM AND FULLY UNDERSTAND THE TERMS THEREOF:
_________________________________________
Parent Print Name
_________________________________________ _____________________
Parent Signature Date
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WESTERN STATES DISTRICT JUNIOR VIRTUAL CONFERENCE CODE OF ETHICS (RULES AND REGULATIONS)
1. All Juniors, Commanders, Counselors, and chaperones must be pre-registered. 2. Juniors, Commanders, Counselors, and chaperones must wear appropriate attire all times. 3. 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. 4. Courtesy and politeness will prevail at all times in meetings and workshops. 5. Juniors should have a low, respective voice tone at all times (no loud talking or outbursts). 6. 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.
7. Respect shall be extended to all members of the Order at all times. 8. Everyone is expected to conduct him or herself in the proper manner that would display the fine character of the organization. 9. Conduct not adhering to the stated rules of the Virtual Conference will be investigated and appropriate action will be taken. 10. The Code of Ethics (Rules and Regulations) will be binding on all Delegates, Chaperones, Commanders, Counselors, and Senior members attending the Conference. 11. Each branch and court will be responsible for making Juniors, Adults and others aware of the code of ethics (Rules and Regulations).
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WESTERN STATES DISTRICT JUNIOR VIRTUAL
CONFERENCE Dress Code
JUNIOR DAUGHTERS’ DRESS CODE JUNIOR KNIGHTS’ DRESS CODE
SATURDAY - MEETING ATTIRE SATURDAY - MEETING ATTIRE - Dress or skirt (should be knee length - no half skirts, tank - Dress shirt
dresses, backless dresses, strapless sundresses, and no - Necktie
Micro miniskirt dresses) - Dress pants with belt (no jeans or sagging pants)
- Shoulder, back, or midriff should be covered at all times
- Pant suit (no shorts, jeans of any kind or color) - Dress shoes (no gym shoes, thongs, or flip-flops)
- Dress Shoes (no sneakers or tennis shoes)
- Zoom appropriate attire
- Zoom appropriate attire
SUNDAY – MASS ATTIRE (Turnout) - White dress (plain, no after five), white suit, or skirt and blouse, white Kufu hat, small white earrings, skin tone stockings (no designer hosiery), white gloves, and white closed shoes toe. All accessories MUST BE WHITE.
SUNDAY - MASS ATTIRE (Turnout)
- Black suit - Black slacks with belt - White shirt - Black Tie - Dress black shoes
Note: Earrings are not allowed at any time
-
______________________________________________
Attendee Signature
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WESTERN STATES DISTRICT JUNIOR VIRTUAL
CONFERENCE SENIOR HIGH SCHOOL INFORMATION FORM
If you graduate from high school in the 2020 / 2021 timeframe, please fill
out this form for informational purposes.
Name:
Birth date:
Council/Court Number:
Council/Court Name:
Graduation Date:
High School:
College you attend or plan to attend: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Major/Field of Interest: _____________________________________
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WESTERN STATES DISTRICT JUNIOR VIRTUAL
CONFERENCE REGISTRATION FORM FOR JUNIORS & ADULTS
DEADLINE: MUST BE EMAIL BY July 3, 2020 ALL PARTICPANTS WILL BE CHARGED A $10.00 REGISTRATION FEE
JUNIOR BRANCH/COURT NAME UNIT No.
CITY STATE DISTRICT
NAME OF ADULT NAME OF JUNIOR AGE PAID
Name Name
Office/Title Office/Title NAME OF ADULT NAME OF JUNIOR AGE PAID
Name Name
Office/Title Office/Title NAME OF ADULT NAME OF JUNIOR AGE PAID
Name Name
Office/Title Office/Title NAME OF ADULT NAME OF JUNIOR AGE PAID
Name Name
Office/Title Office/Title NAME OF ADULT NAME OF JUNIOR AGE PAID
Name Name
Office/Title Office/Title
TOTAL ADULTS TOTAL JUNIORS TOTAL AMOUNT ($) REMITTED
WILL YOU BE ATTENDING
* Make as many copies as necessary.
JUNIOR COMMANDER/COUNSELOR NAME Yes No
TELEPHONE ALTERNATE TELEPHONE EMAIL ( ) ( ) Shirt Size:
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WESTERN STATES DISTRICT JUNIOR VIRTUAL CONFERENCE
Committee Sign-Up Worksheet DEADLINE: MUST BE EMAIL BY July 3, 2020
JUNIOR BRANCH/COURT NAME UNIT NO.
JUNIOR COMMANDER/COUNSELOR NAME
ADDRESS
CITY STATE ZIP
HOME TELEPHONE WORK TELEPHONE CELLULAR TELEPHONE
JUNIORS NAME
Send Junior Knights Form to the WSDC Director and send Junior Daughters Form to the WSDC Immediate Past Directress:
Brother William Lewis Jr., Director Lady Lydia Price, Immediate Past Directress 10006 Pelham Park Ave. 16214 South McKinley Avenue
Las Vegas, Nevada 89148 Carson, California 90746 [email protected] [email protected]
CONFERENCE COMMITTEES
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2020 Western States District Junior Virtual Conference RESOLUTION FORM
DEADLINE: MUST BE EMAILED BY July 3, 2020
Resolutions submitted to the Western States District Junior
Conference are to be typed or printed and bear the Senior
Council/Court Seal. Please state the Article(s), Section(s) and the
page number(s) of the Constitution/By-Laws affected by each
resolution. Return the form with your Conference Package.
WHEREAS
BE IT RESOLVED
_
Junior Grand Knight/Grand Lady Junior Financial Secretary
Junior Branch/Court Name and Number Junior Commander/Counselor
(SEAL)
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2020 Western States District Junior Virtual Conference
SOUVENIR BOOKLET ADVERTISEMENT
PATRONS INFORMATION DEADLINE: MUST BE EMAILED BY July 11, 2020
Dear Friends, Please support the Western States District Junior Knights and Junior Daughters of the Knights of Peter Claver and Ladies Auxiliary on their 2020 Western States District Junior Conference. (July 18-19, 2020) As always, we are grateful for your love and support, once again, as we plan to attend our 2020 Western States District Junior Conference.
Our theme: Unity, Equality, and Love - Together in Hands
Name:
Company/Affiliation: (Cn/Ct No.)
Address:
City: State: Zip
Telephone: Fax:
Email:
Please attach a camera-ready copy of your business card, advertisement, or other appropriate information as you want it to appear in the souvenir book. The prices are listed below. Please indicate by marking a check in the box next to the desired advertisement. Ad format should be submitted: PNG, JPEG, TIFF (No blurry Submission) email to submit ads: [email protected]
Note: No Ad will be placed until money is received.
SOUVENIR BOOKLET
ADVERTISMENT PRICES
Full Page - $50.00
Half Page - $25.00
Quarter Page - $15.00
Make Council / Court, Certified, Business & Personal Checks and Money Orders payable to: WSDC Joint Junior Account Send to: Brother Leroy Titus 13282 Briarwood Street Cerritos, California 90703 Lady Karen Pinson 809 West 169th Place Gardena, California 90247
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2020 WESTERN STATES DISTRICT JUNIOR
VIRTUAL CONFERENCE
FAMILY CLAVER ACTIVITIES
JUNIOR BRANCH/COURT NAME
UNIT NO.
JUNIOR COMMANDER/COUNSELOR NAME
ADDRESS
CITY STATE ZIP
HOME TELEPHONE WORK TELEPHONE CELLULAR TELEPHONE
List activities (religious, community service, seminars, workshops, etc.) the Senior Council/Court has done for the Junior Branch/Court.
Send Junior Knights Form to the WSDC Director and send the Junior Daughters Form to the WSDC Immediate Past Directress:
Brother William Lewis Jr., Director Lady Lydia Price, Immediate Past Directress 10006 Pelham Park Ave. 16214 South McKinley Avenue Las Vegas, Nevada 89148 Carson, California 90746 [email protected] [email protected]
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2020 WESTERN STATES DISTRICT JUNIOR VIRTUAL CONFERENCE
COMMUNITY SERVICE PROJECTS
JUNIOR BRANCH/COURT NAME UNIT NO.
JUNIOR COMMANDER/COUNSELOR NAME EMAIL
ADDRESS
CITY STATE ZIP
HOME TELEPHONE WORK TELEPHONE CELLULAR TELEPHONE
List all activities (religious, community service, seminars, workshops, etc.) of the Junior Branch/Court.
Send Junior Knights Form to the WSDC Director and send the Junior Daughters Form to the WSDC Immediate Past Directress:
Brother William Lewis Jr., Director Lady Lydia Price, Immediate Past Directress 10006 Pelham Park Ave. 16214 S. McKinley Avenue Las Vegas, Nevada 89148 Carson, California 90746 (310) 808-3057 (310) 386-0007
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WESTERN STATES DISTRICT JUNIOR VIRTUAL CONFERENCE
CREDENTIALS FORM DEADLINE: MUST BE EMAILED BY July 3, 2020
JUNIOR BRANCH/COURT NAME UNIT No.
CITY STATE DISTRICT
Section 1 – Junior Grand Knight/Junior Grand Lady Jr. Grand Knight and Jr. Grand Lady are automatic delegates. Do not list them as your delegates in Section 2.
JUNIOR GRAND KNIGHT/LADY AGE ATTENDING (Y/N)
JUNIOR DEPUTY GRAND KNIGHT/JUNIOR VICE GRAND LADY AGE ATTENDING (Y/N)
Section 2 – Delegates Each Branch/Court is entitled to three (3) delegates. The Junior Grand Knight /Junior Vice Grand Lady can serve as a delegate if the Junior Grand Knight/Junior Grand Lady is attending the Conference. In order for this to happen, you must place his/her name on the delegate line.
DELEGATES AGE
Section 3 – Alternate Delegates An Alternate delegate will replace the delegate if the delegate is unable to attend the Conference business session.
ALTERNATE DELEGATES AGE
___________________________________ Signature of Junior Grand Knight/Lady (Seal) ___________________________________ Signature of Junior Commander/Counselor ___________________________________ Signature of Senior Grand Knight/Lady
Brother William Lewis Jr., Director Lady Lydia Price, Immediate Past Directress 10006 Pelham Park Ave. 16214 South McKinley Avenue Las Vegas, Nevada 89148 Carson, California 90746 [email protected] [email protected]