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Charter Membership and Club Officer InformationJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
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 $ 22.50 $ 15.00 $ 7.50 $ 45.00 $ 37.50 $ 30.00 $ 22.50 $ 15.00 $ 7.50 $ 45.00 $ 37.50 $ 30.00
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For questions, please contact
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newclubs@toastmasters.org
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Term of Office (check only one box)
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NOTE: Club Constitution for Clubs of Toastmasters International and Addendum of Standard Club Options state club officer terms must conform to the above schedule. Only those clubs that meet weekly may elect officers for semiannual terms. Please provide email addresses for all officers, which is a requirement to conduct club business online. Minimum officer requirements: Clubs must indicate below at least a Club President, one Vice President, and a Club Secretary or Club Secretary/Treasurer, and these offices must be held by three different individuals.
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Member CountMembership TypePrevious Club NumberMember NumberClub Officer RoleLast Name/ SurnameFirst NameMiddle NameOrganization/ In Care ofAddress Line 1Address Line 2CityState or ProvinceCountryPostal CodeEmail AddressHome Phone NumberMobile Phone NumberNew Member FeesMembership DuesStart DateProrated Renewal AmountTotalCredit Card NumberCredit Card Exp DateName on Credit CardCheck Number
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1 $ -
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2 $ -
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3 $ -
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4 $ -
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5 $ -
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6 $ -
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7 $ -
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8 $ -
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9 $ -
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10 $ -
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11 $ -
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13 $ -
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14 $ -
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15 $ -
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16 $ -
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17 $ -
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18 $ -
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19 $ -
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20 $ -
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21 $ -
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22 $ -
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24 $ -
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25 $ -
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26 $ -
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27 $ -
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28 $ -
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29 $ -
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30 $ -
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31 $ -
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32 $ -
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33 $ -
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34 $ -
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35 $ -
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37 $ -
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45 $ -
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48 $ -
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49 $ -
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50 $ -
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Total $ -
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By signing this form, I confirm that I have gained the consent of all club officers and members listed to share their information for the sole purpose of Toastmasters International's essential communications. I confirm that a completed charter member application for each charter member is on file with the club and will be retained by the club. The application contains both the signature of the new member and the signature of the club officer. I acknowledge that my electronic signature on this document is legally equivalent to my handwritten signature.
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Signed
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Name
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Date
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