CLUB COACH

APPOINTMENT

TCS Maitree Orators 2.0 Toastmasters Club

Club Name ____________________________________________  Club Number _____________________ 
02247135 District ____________
120

Name______________________________________
Arockia Meetpan Arul Francis Name__Muthaiahbabu
______________________________________
Dharmaraj

Member Number_____________________________
6660903 Member Number______________________________
6660155

Address__Plot
___________________________________
No-65, Kannagi StreetShrudi Sai Nagar, MadambakkamDharma Illam,9a Middle Street,Tallakulam
Address______________________________________

City________________________________________
Chennai Madurai
City_________________________________________

State/Province_______________________________
Tamil Nadu Tamil Nadu
State/Province________________________________

Country____________________________________
India Country______________________________________
India

Postal Code_________________________________
600126 625002
Postal Code___________________________________

Home Club Number__06128127

_________________________ Home Club Number____________________________
07054417

A club must have at least one but not more than 12 members to qualify for a club coach appointment.

Up to two club coaches may be appointed per club. A club coach is recognized and receives credit if the club to which
he or she is assigned achieves Distinguished Club or better by June 30 of the current year or by the following June 30.
Coaches may not be a member of the club at the time of the appointment.

________________________________   Approved by: ______________________________________________________________

APPOINTMENT DATE DISTRICT DIRECTOR OR CLUB GROWTH DIRECTOR

4This form must be submitted to World Headquarters at the time of appointment.

4A club must have at least one but not more than 12 members when a coach is appointed, and the coach cannot be a
member of that club until their appointment request has been processed.

4This form can be submitted by email to clubcoach@toastmasters.org

Rev. 5/2016  Item 1152