MEMBERSHIP RECRUITMENT DATE______________

This is to certify that the following Marine Corps League member has met the minimum criteria as established by the National Junior Vice Commandant’s Awards Program. And has also met the Department’s requirement by recruiting (5 or more) new members for his / her Detachment during the period from 1 July _______ and 30 June _________.

Year Year

Detachment_________________________________________ Number__________ Department of Louisiana

Recruiter’s name ___________________________ MCL Membership #______________ PLM # _________

NAMES OF THE NEW MEMBERS

(1) __________________________________ (16) ____________________________________

(2) __________________________________ (17) _____________________________________

(3) __________________________________ (18) _____________________________________

(4) __________________________________ (19) _____________________________________

(5) __________________________________ (20) _____________________________________

(6) __________________________________ (21) _____________________________________

(7) __________________________________ (22) _____________________________________

(8) __________________________________ (23) _____________________________________

(9) __________________________________ (24) _____________________________________

(10) _________________________________ (25) _____________________________________

(11) _________________________________ (26) _____________________________________

(12) _________________________________ (27) _____________________________________

(13) _________________________________ (28) _____________________________________

(14) _________________________________ (29) ____________________________________

(15) _________________________________ (30) _____________________________________

(List any additional names on the back of this form)

The Above CERTIFIED TRUE and CORRECT:    C                                                                                                                                                       ___________________________________________
                    Detachment Commandant

        _____________________________________________
                    Detachment Adjutant / Paymaster

Note: This FORM must be in the Louisiana Department Jr. Vice Commandant’s hands no later than 1 May this year!

Mail to: ________________________________________

            ________________________________________

            ________________________________________

            ________________________________________

Notice! Another form (Enclosure Four (4) from National’s Bylaws / Administration Procedure) must be sent to National Jr. Vice Commandant (by 15 July) to have this recruiter nominated for National’s Awards which will be given at National Convention each August.

Enclosure LA3

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