Membership Application and Payment Information
To become a member of Centraler Toastmasters Club, please
1. Completely fill out this Membership Application in Part 1
2. Pay membership fees in accordance with Payment Information in Part 2

For questions, please contact

Your membership application will be processed by us upon completion of this Membership Application accompanied by full payment of membership fee and applicable dues.
Part 1: Membership Application
Last Name / Surname *
First name *
Middle name
Email *
Phone number *
Address *
The monthly Toastmasters magazine will be sent to this address
Are you a member of Toastmasters International?
If you are registered with another Toastmasters club then you are already a member of Toastmasters International. If you never joined a Toastmasters club, or your membership from another club is expired, then please leave blank.
Name of Sponsor
if you are sponsored or recommended by a member, please provide his or her name
Membership fees
Our membership fees are used to cover dues and fees payable to Toastmasters International and expenses of our club for educational purposes. Dues and fees are payable in advance and are not refundable or transferable from one member to another. Our club is a private association and we reserve the right to reject your application in which case any payment made will be returned.

1. New member fee: HK$300 (payable if you never joined a Toastmasters club before)

2. Membership dues: HK$1,800 (paid once a year by all members, membership due are pro-rated from the member's start month up to and including March next year)

Start month (pro-rated membership dues, HKD)
■ April $1,800
■ May $1,650
■ June $1,500
■ July $1,350
■ August $1,200
■ September $1,050
■ October $900
■ November $750
■ December $600
■ January $450 + $1,800 = $2,250
■ February $300 + $1,800 = $2,100
■ March $150 + $1,800 = $1,950

Total payment: Total of 1 and 2
I want my membership to begin on (month/year): *
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 and 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 agree 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 officers 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: I understand that the majority of the data requested in this application is necessary for administrative and planning purposes.
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
If you would rather not receive non-essential communications from Toastmasters International, please check here
Verification of Applicant *
By clicking "Yes" 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).
Part 2: Payment Information
Your application will not be processed by us until it is accompanied by new member fee and applicable dues as indicated above. Our club is a private association and we reserve the right to reject your application in which case any payment made will be returned.

The following payment methods are accepted:
1. Bank transfer: Please deposit the total payment into HSBC bank account 154-629802-001 (Account name: Centraler Toastmasters Club).
2. Payme/Fast Payment System(FPS): +852 5501 5590 (Gary Miles, President of Centraler Toastmasters Club) Please state your full name and "Centraler membership fee".

Thereafter, email your payment receipt/payment confirmation together with your full name to and

For questions, please contact
I have emailed payment receipt/payment confirmation together with my name to the emails indicated above. *
Personal Information Collection Statement
The personal information provided by you to us will be used to facilitate communication between you and us and for educational purposes and will be kept confidential by us.
Never submit passwords through Google Forms.
This form was created inside of Centraler Toastmasters. Report Abuse