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Club Coach
Please fill up this form if you wish to be a Club Coach during the program year 2019-20 in District 92.
For any queries please contact the Club Growth Director Office on
d92.cgdo@gmail.com
.
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* Indicates required question
Full Name
*
Your answer
Phone Number
*
Your answer
Email address
*
Your answer
TMI Membership ID
Your answer
Club Name
*
Your answer
Which Timings work best for you ?
*
Weekday mornings
Weekday evenings
Weekends
Flexible - Any timing works
Required
Specify the Location /Area you work at ?
Your answer
Specify the Location / Area you live in ?
Your answer
Name the Club officer Roles you have served till date
*
President
Vice President - Education
Vice President - Membership
Vice President - Public Relations
Secretary
Treasurer
Sergeant -at - Arms
Required
Any other roles outside the club, that you have taken previously ?
*
Pathways Ambassador / Guide
Event chair for Area / Division / District events
District officer role - Area Director / Division Director / Top 9 in District
Club Sponsor
Club Mentor
Club Coach
Other:
Required
List the Educational Awards filed by you so far :
*
Competent Communicator
Advanced Communicator Bronze
Advanced Communicator Silver
Advanced Communicator Gold
Competent Leader
Advanced Leader Bronze
Advanced Leader Silver
Pathways Level 1
Pathways Level 2
Pathways Level 3
Pathways Level 4
Pathways Level 5
Distinguished Toastmaster
Required
Please explain how intend to make a difference to the Club Coach role you take up?
*
Your answer
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