Membership Application
To become a club member, please 1. Completely fill out and sign the Membership Application . 2. Completely fill out and sign the Payment Information document (page 3). 3. Submit both completed and signed documents to a club officer. 4. Please check here if you use assistive technology (such as a screen reader) to view your educational materials. For questions, please contact membership@toastmasters.org .
Membership Application
Club Information This section is completed by a club officer. _______________________________________________________________________________________________________________________________________ Club number Club name Club city
Membership Type This section is completed by a club officer.
Applicant Information This section is completed by the applicant.
Male
Female
Non-binary
Decline to respond
New Dual
Reinstated (break in membership) Renewing (no break in membership)
_________________________________________________________________________________________ Last name/Surname First name Middle name
Transfer (If applicant is transferring from another club, please fill in the four lines below.)
Any correspondence mailed to you will be sent to the following address:
_________________________________________________________________________________________ Organization/In care of _________________________________________________________________________________________ Address line 1 (limit 35 characters) _________________________________________________________________________________________ Address line 2 (limit 35 characters) _________________________________________________________________________________________ City State or province _________________________________________________________________________________________ Country Postal code
_______________________________________ Date of transfer (MM/YYYY) _______________________________________ Previous club name _______________________________________ Previous club number _______________________________________ Member number
_______________________________________________________________________________________________________________________________________ Home phone number Mobile phone number Email address Toastmasters International Dues and Fees This section is completed by the applicant with the help of a club officer. Dues and fees are payable in advance and are not refundable or transfer- able from one member to another . 1. New member fee (US$25) US$ _________ Paid only by new members, this fee covers the cost of the first education path, online copy of The Navigator, and processing 2. Membership dues US$ _________ Paid twice a year by all members, membership dues are pro-rated from the member’s start month: Date my membership began: __________________________________________ Month/Year 3. Sales Tax US$ ________ Club Dues and Fees Worksheet Club dues must be paid directly to the club. World Headquarters Go to www.toastmasters.org/Sales-Tax to determine your state’s tax 4. Total payment to Toastmasters International US$ ________ Total of 1, 2, and 3.
cannot process payments for club dues. International Fees and Dues $ ______________ (from line 4 above) Club new member fee ______________ Club dues ______________ Total payment to club ______________
DISTRICTED US$60.00 $_________
October November December January February March
or or or or or or
April May June
50.00 _________ 40.00 _________ 30.00 _________ 20.00 _________ 10.00 _________
July
August
September
Page 1
Sponsor of New, Reinstated, or Dual Member Transfer and renewing members are not eligible to be sponsored. This section is completed by a club officer. Sponsor’s last name/surname and member number are required fields. �������������������������������������������������������������������������������������������������������������������������������������� Sponsor’s last name/surname Sponsor’s first name Sponsor’s member number Member’s Agreement and Release Consistent with my desire to take personal responsibility for my conduct, individually and as a member of a Toastmasters club, I agree to abide by the principles contained in A Toastmaster’s Promise, the Toastmasters International Governing Documents, and my club. I will refrain from any form of discrimination, harassment, bullying, derogatory, illegal, or unethical conduct, and I understand that if I engage in such conduct, I may be responsible to reimburse Toastmasters International, my club or other clubs, or other individuals involved with Toastmasters, for any damages, losses, or costs resulting from my conduct. Understanding that Toastmasters programs are conducted by volunteers who cannot be effectively screened or supervised by Toastmasters International or its clubs, I release and discharge Toastmasters International, its clubs, governing bodies, officers, employees, agents, and representatives from any liability for the intentional or negligent acts or omissions of any member or officer of my club or other clubs, or any officer of Toastmasters International. Should a dispute of some nature arise, I expressly agree to resolve all disputes, claims, and charges relating to Toastmasters, Districts, clubs, and Toastmasters members in accordance with Protocol 3.0: Ethics and Conduct. By submitting this application, I expressly agree to the following: ■ The collection, use, and processing of the personal information I provide to Toastmasters in this Membership Application for the purposes of organization administration, payment of my dues, and inclusion of my contact information in a members’ directory that will be distributed to members and employees of Toastmasters. In addition, the collection, use, and processing of my personal information collected by Toastmasters International through Toastmasters’ website and by electronic communications. ■ That my information may be accessed and used by Toastmasters, its employees and agents, District leaders, and club officers. ■ Maintain changes to my personal contact information to ensure it is accurate and current by updating my personal profile page located on the Toastmasters International website: www.toastmasters.org/Login . I understand that the majority of the data requested in this application is necessary for administrative and planning purposes. Occasionally we would like to contact you with details of services, educational updates, and organizational updates. If you consent to us contacting you for this purpose, please check the box below corresponding to acceptable contact methods: Mail Email Phone
If you would rather not receive non-essential communications from us, please check here For our full privacy policy, you may visit www.toastmasters.org/Footer/Privacy-Policy .
Verification of Applicant By my signature below, I agree to the terms of A Toastmaster’s Promise and the Member’s Agreement and Release stated above, and certify that I am 18 years of age or older (in compliance with the Toastmasters Club Constitution for Clubs of Toastmasters International). I acknowledge that my electronic signature on this document is legally equiva- lent to my handwritten signature.
A Toastmaster’s Promise As a member of Toastmasters International and my club, I promise To attend club meetings regularly To prepare all of my projects to the best of my ability, basing them on the Toastmasters education program To prepare for and fulfill meeting assignments To provide fellow members with helpful, constructive evaluations To help the club maintain the positive, friendly environment necessary for all members to learn and grow To serve my club as an officer when called upon to do so To treat my fellow club members and our guests with respect and courtesy To bring guests to club meetings so they can see the benefits Toastmasters membership offers To adhere to the guidelines and rules for all Toastmasters education and recognition programs To act within Toastmasters’ core values of integrity, respect, service, and excellence during the conduct of all Toastmasters activities
���������������������������������������������������������������� Applicant’s signature Date (MM/DD/YYYY)
Verification of Club Officer I confirm that a complete Membership Application, including the signatures of the new member and a club officer, is on file with the club and will be retained by the club. By my signature below, I certify that this individual has joined the Toastmasters club identified. As a club, we will ensure that this member receives proper orientation and mentoring. I acknowledge that my electronic signature on this document is legally equivalent to my handwritten signature. ���������������������������������������������������������������� Club officer’s signature Date (MM/DD/YYYY) In order for this application to be valid, both signatures are required.
Page 2
The club officer must follow the instructions below once the Membership Application and Payment Information documents are received. 1. Sign and date the applicant’s Membership Application . 2. Submit the Membership Application and Payment Information documents online by logging in to www.toastmasters.org/ClubCentral . You can also mail the documents to Club and Member Support, Toastmasters International, 9127 S. Jamaica St., Suite 400, Englewood, CO 80112, U.S.A., or fax to +1 303-799-7753. Please use only one of these methods to avoid duplication. If the member is transferring, the application must be submitted to World Headquarters by email, mail, or fax. 3. After receiving confirmation that Toastmasters International has received and processed the Membership Application and Payment Information , the club officer must: a. Retain the applicant’s Membership Application with other club documentation. While held, the application should be kept secure, such as in a lock box, or destroyed once it is digitally retained. It is up to your club and your country’s privacy guidelines on how long the application should be retained. b. Immediately destroy the applicant’s Payment Information document (page 3) and any copies in the club officer’s or club’s possession, including all electronic copies.
Payment Information
Payment Method to Toastmasters International This section is completed by the applicant and is for payment to World Headquarters only (the amount listed in line 4 on page 1). World Headquarters does not collect club dues.
Check or money order Check or money order must be for U.S. funds drawn on a U.S. bank.
MasterCard Visa AMEX Discover
US$_ __________________________________________________ Amount
______________________________________________________ Check or money order number
US$_ __________________________________________________________ Amount
______________________________________________________________ Card number
Other
______________________________________________________________ Expiration date
______________________________________________________ Other
______________________________________________________________ Name on card
______________________________________________________________ Signature
Check box if Billing Address is the same as Shipping Address
______________________________________________________________________________________________________________________________________ Address line 1 ______________________________________________________________________________________________________________________________________ Address line 2 ______________________________________________________________________________________________________________________________________ City State or province ______________________________________________________________________________________________________________________________________ Country Postal code
© 2022 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. Item 800 Rev. 09/2025
Page 3
Page 1 Page 2 Page 3Made with FlippingBook Publishing Software