Club Ambassador Visitation Survey

I would like to:*

Report my Ambassador visit to another club
Verify a visit to my home club by an Ambassador

Name*

First Last

Email*

Toastmasters Member ID*

Club Name*

Please enter the name of the club that was visited.

Date of Visit*

Did you visit:*

Face-to-Face
Virtually

Did you present a manual speech?*

Yes
No

Did you bring a guest?*

Yes
No

Did you perform a meeting role?*

Yes
No

List three unique things about this club or three lessons learned*

Favorite phrase/thought at this meeting*

Name of visiting Club Ambassador*

First Last

Usefulness of the Club Ambassador visit*

Very useful
Somewhat useful
Somewhat not useful
Not useful

What changes will your club make resulting from this visit?*

Will you send club members to visit the Ambassador's Club?*

...as a result of this visit

Yes
No

Are you interested in visiting low membership clubs?*

...to boost their critical mass and provide constructive ideas for improving club quality

Yes
No

Will you contact the Club Ambassador Chair to send more Club Ambassadors?*

...from good membership clubs?

Yes
No

Did you take any photos?

Yes
No

Got a link where photos were posted on social media?

Facebook: Click the post date to get a direct link

Upload photos (optional)

Uploaded photos may be used publicly on the District website and social media sites including Facebook.

Drop files here or

Accepted file types: jpg, png, Max. file size: 5 MB, Max. files: 50.

By participating in District 48’s Club Ambassador Program, I understand that I can only receive credit for visiting clubs of which I am not a member of on the date of the visit. If I am serving as an Area Director, I can only receive credit for visiting clubs outside my Area of responsibility. I also understand I cannot receive credit for multiple visits to the same club.

By participating in District 48’s Club Ambassador Program, I understand that our club and the Club Ambassador visiting us benefit. I am glad for my club to have participated in the program.

Name

This field is for validation purposes and should be left unchanged.

TOASTMASTERS DISTRICT 48

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