Individual Membership Program Tracking Sheet
Distribute a copy of this form to each member of your club and encourage
them to use it to track their progress as a new member sponsor.
New Member Name Date Joined

Application Mailed or Submitted Online

1      
2      
3      
Congratulations! You have qualified to receive a District 53
Governor's Award Ribbon
for sponsoring three (3) members!
4      
5      
Congratulations! You have qualified to receive a
"Find Your Voice. Serve The World" pin for sponsoring five (5) members!
6      
7      
8      
9      
10      
Congratulations! As an outstanding member sponsor you have qualified to
receive a special "Gold Star" pin for sponsoring ten (10) new members!
11      
12      
13      
14      
15      
Impressive! As a 15-member sponsor you have qualified to receive a special tie or scarf!
You’ve also made a significant contribution to your club’s long-term success!
All Toastmaster members are automatically entered in the individual recognition programs and will be recognized (Awards mailed by WHQ) if you qualify. However, to receive credit as a sponsor your name must appear on the application for Toastmasters club membership (Form 400) along with your home club number. Please print or type information legibly. No changes will be made to the applications once they are received by World Headquarters.