Advanced Leader Award Application - Free Download
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PLEASE PRINT OR TYPE:
Member No. Club Name & No. ________________________________________ District ___________
Name ___________________________________________________________________________________ Date __________________________
Permanent Address Change
Address 1 _______________________________________________________________________________________________________________
Address 2 _______________________________________________________________________________________________________________
City _________________________________________________ State/Province ________________________ ZIP/Postal Code _______________
Country ______________________________________ Email Address______________________________________________________________
Complete all requirements before submitting award applications to World Headquarters. Check award for which you are applying.
Advanced Leader Bronze (complete Section I)
Advanced Leader Silver (complete Section II)
Distinguished Toastmaster (complete Section III)
ADVANCED LEADER/DISTINGUISHED TOASTMASTER (AL) (DTM)
REV. 5/2014 ITEM 1228
I . Advanced Leader Bronze (ALB)
4 Achieved Competent Leader (CL) award
for completing Competent Leadership manual Date ______________ Club/District No. ___________________
4 Achieved Competent Communicator (CC) award
(or achieved Competent Toastmaster award) Date ______________ Club/District No. ___________________
4 Served at least six months* as a club oﬃcer (president, vice president education, vice president membership,
vice president public relations, secretary, treasurer, or sergeant at arms) and participated in the preparation of a
Club Success Plan while serving in this oﬃce.
(* You must have served as an ocer from July 1 through December 31 or January 1 through June 30 to fulll this requirement. Other six-month
periods do not qualify. The six months must be completed at the time you submit this application.)
Oﬃce held ______________________________________________________________ in Club No. _______________
Served six months as follows (check one and ﬁll in year)
______ July 1 – December 31, ______ ______ January 1 – June 30, ______
Date you helped prepare a Club Success Plan for your club ________________________ ____________
(must coincide with above oﬃcer term)
4 While serving in above oﬃcer term, participated in a district-sponsored club-oﬃcer training program.
(Applicants in undistricted clubs need not complete this requirement.)
Date attended training _________________________________________________________________________________
DTM APPLICANTS MUST PROVIDE A STREET ADDRESS, NOT A P. O. BOX
REQUIRED FOR DTM APPLICATIONS
You must be a current member of the club listed below at the time your application is received at World
Headquarters to be eligible for the award.
4 Complete both sides of this application.
4 A current club oﬃcer must sign and date the application.
4 Ask a current club oﬃcer to submit your application online at www.toastmasters.org/members.
If no current oﬃcer has online access, mail OR fax (one method only please) the completed form to:
Member Services - Education Awards Fax: 949.858.1207
P.O. Box 9052, Mission Viejo, CA 92690 USA
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