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Olympic Club Ambassador Program
Please fill out for credit towards the Olympic Club Ambassador Program
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* Indicates required question
What is your name?
*
Your answer
What is your email address?
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Your answer
What is your home club?
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Your answer
What is the name of the club or District event you Attended?
*
Your answer
What functionary role did you have at this event? (If none put N/A)
Your answer
Date of Visit or District Event?
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MM
/
DD
/
YYYY
Location of Club or District event(If online include a Zoom link)
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Your answer
Club Officer Email Address (If District event put N/A)
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Your answer
Is this club or District event in District 30
*
Yes
No
Did you become a member of the club you visited?
Yes
No
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What did you learn from this visit, and are there any unique, fun, or new ideas you will bring back to your club?
*
Your answer
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