Application for "Spirit of Success" Certificate

This form is used to apply for the "Spirit of Success" Certificate.

TO QUALIFY ...
The Spirit of Success 5-speech certificate is awarded to any Toastmaster who has completed the first 5 assignments in the 'Communication and Leadership' manual.

The Spirit of Success Advanced Manual certificate is awarded to any Toastmaster who has completed all 5 assignments in any Advanced Manual.

These certificates are District 72 awards only and cannot be obtained by making an application to World Headquarters.  This criterion applies only to these two awards, all other awards - CTM etc must be made to Toastmasters International using their online forms.

The Club President, V.P. Education, or Secretary should complete this form. 
Every effort is made to issue a certificate within 3 days of the receipt of an application. It will be sent directly to the mailing address listed below.

The recipient should be formally presented with the Spirit of Success Certificate at the Club awards ceremony or during General Business at a regular club meeting.  Presentation of the certificate could also be made as a speech from the Special Occasion Speeches manual - Presenting an Award.  Up to 5 recipients can be entered on this form at one time.

Club details
Club Name:
Club Number:
Postal Address for Certificate/s:
1st 5 speeches in Communication and Leadership Manual (up to 5 recipients can be listed here)
1. Recipient's Full Name:
2. Recipient's Full Name:
3. Recipient's Full Name:
4. Recipient's Full Name:
5. Recipient's Full Name:
Advanced Manual Completion (up to 5 recipients can be listed here)
1. Recipient's Full Name:
Name of Advanced  Manual:
2. Recipient's Full Name:
Name of Advanced Manual:
3. Recipient's Full Name:
Name of Advanced Manual:
4. Recipient's Full Name:
Name of Advanced Manual:
5. Recipient's Full Name
Name of Advanced Manual:
Submitter details
Name:
Club Officer Position:			junk--Select--PresidentVP EducationSecretaryOther If Other, please state:
Email address:
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Thank you!  You should receive the certificates within 3 working days at the postal address listed above.