DISTRICT LEADERNOMINATING FORM

These materials are confidential. District Leadership Committee (DLC), upon completion of voting, submit all forms to the committee chair to destroy after the final report has been distributed to the district director.

Are you interested in nominating yourself or someone else for a district leader position? If so, please complete the form below and submit it to your district director or to the DLC. If you are nominating someone besides yourself, you may submit more than one person’s name for each position.

To be nominated or elected and to hold office, a member must meet the following requirements: Be a member in good standing of a Toastmasters club in good standing. Meet the qualifications of the position. Consent to being nominated and sign the Officer Agreement and Release Statement.

I wish to have the director or DLC consider the following member for the office of: District Director Program Quality Director Club Growth Director Division Director (please specify division _________________)

If applicable:

Area Director (please specify area ____________ /division ____________) Administration Manager Finance Manager Public Relations Manager

Name of nominee _______________________________________________ Are you nominating yourself ? Yes No

Address ______________________________________________________________________________________________

City _________________________________________________________________________________________________

State/Province _________________________ Postal code _________________ Country ____________________________

Telephone __________________________________________________________ Member number ___________________

Email ________________________________________________________________________________________________

Home club name _________________________________________________________Club number _________________

Educational Awards CC ACB ACS ACG CL ALB ALS DTM

Other _________________________________

To assist the district leadership committee member in their deliberations, please attach: Additional information you would like to include about this candidate. A description of any club and district offices held by the nominee (include dates of service if possible). Why you believe the nominee should be considered for the specified position.

Submitted by _________________________________________________________ Date __________________________

Mail, fax or email to your district director or DLC.Forms are submitted directly to district director/DLC. Please see your district website for specifics. https://www.toastmasters.org/Leadership-Central/District-Websites

© 2016 Toastmasters International. All rights reserved. Toastmasters International, the Toastmasters International logo and all other Toastmasters International trademarks and copyrights are the sole property of Toastmasters International and may be used only by permission.Rev. 12/2016 Item 450C

Toastmasters member since:

Education: _____________________________________________________________________________________________

___________________________________________________________________________________________________

______________________________________________________________________________________________________

Toastmasters offices held and terms of service:

Toastmasters honors and recognition:

Relevant work experience and how it relates to Toastmasters and your role as a District officer:

What experience do you have in strategic planning?

What experience do you have in the area of finance?

1

Candidate’s Name:

Candidate’s Office: District Number:

DISTRICT LEADERBIOGRAPHICAL INFORMATION

2

What experience do you have in developing procedures?

What lessons did you learn from previous leadership positions?

Why do you want to serve as a district officer?

In your opinion, what are the district mission’s major objectives and how would you work to achieve them?

Additional information about yourself:

© 2016 Toastmasters International. All rights reserved. Toastmasters International, the Toastmasters International logo and all other Toastmasters International trademarks and copyrights are the sole property of Toastmasters International and may be used only by permission.

Rev. 12/2016 Item 450H

8/11/2019 Toastmasters International -Offices Held

https://www.toastmasters.org/my-toastmasters/profile/offices-held 1/1

1 - 6 of 6Rows per page: 25

Search:

6562921 TAEGUS Toastmasters Club Secretary Jul. 01, 2019 Jun. 30, 2020

6562921 TAEGUS Toastmasters Club President Jul. 01, 2018 Jun. 30, 2019

4657736 DSO Toastmasters Club Vice President Membership Jul. 01, 2017 Jun. 30, 2018

6594893 Bollywood Toastmasters Club Vice President Membership Jul. 01, 2017 Jun. 30, 2018

4657736 DSO Toastmasters Club Vice President Membership Jul. 01, 2016 Jun. 30, 2017

6594893 Bollywood Toastmasters Club Vice President Membership Jun. 29, 2017 Jun. 30, 2017

OFFICES HELD

Excel Print

Number Name Position Start Date End Date

8/11/2019 Toastmasters International -Club Support History

https://www.toastmasters.org/my-toastmasters/profile/club-support-history 1/1

1 - 3 of 3Rows per page: 25

Search:

6892541 ESAG Toastmasters Club Mentor In Progress *

6562921 TAEGUS Toastmasters Club Sponsor Complete May. 19, 2019

6778108 IMT Dubai Toastmasters Club Mentor Complete Jun. 7, 2019

*Pending: This role has been officially assigned and is pending further requirements to be met for credited achievement.

CLUB SUPPORT HISTORY

Excel Print

Club Number Club Name Role Award Status Awarded Date

8/11/2019 Toastmasters International -Additional Roles

https://www.toastmasters.org/my-toastmasters/profile/additional-roles 1/1

1 - 2 of 2Rows per page: 25

General AchievementsSearch:

Pathways Guide Dec. 5, 2018

Pathways Ambassador Mar. 1, 2018

ADDITIONAL ROLESSelect Table:

General Achievements

Excel Print

Description Date Awarded