District 18
District 18 Officer Nominating Form
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I wish to have the Nominating Committee consider the following person for the office of (circle one):

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   District Governor
   Lt. Governor Education & Training
   Lt. Governor Marketing
   Division A Governor
   Division B Governor
   Division C Governor
   Division D Governor
   Division E Governor
   Division F Governor
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Please Print
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Name: __________________________________________________________________
Educational Level: (circle highest attained):         CTM   ATM-B    ATM-S    ATM-G    DTM
                                                                               CC   ACB   ACS   ACG
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Leadership Lever (circle highest attained):             CL   AL   ALB   ALS
Address _________________________________________________
City __________________________________
State _______________ ZIP __________
Telephone (H) _____ - _____ - _________ (W) _____ - _____ - _________
FAX _____ - _____ - _________
e-mail: ________________________________________
Home Club Name _________________________________
Club No. _________________
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List the Club and District offices in which this person has served and the dates of service. Describe this Toastmaster's qualifications for office and fitness to serve. Please attach any other information about this candidate that may be helpful in assisting the Nominating Committee. Use additional sheets, if necessary.

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_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
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Submitted by: ____________________________________
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Raymond Kane
Nominating Committee Chair
8 Custer Drive
East Berlin PA 17316-9366

Deadline: March 22, 2008

email: Raymond1943@comcast.net