Membership Application PrefixMr.Mrs.Ms.Mx.MissDr.Prof.First Name *Middle NameLast Name *Email Address *Confirm Email Address *Phone *Street AddressApartment, suite, etcCity *State/Province *ZIP / Postal code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint HelenaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. MartinSt. Pierre & MiquelonSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaSão Tomé & PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluU.S. Virgin IslandsUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweMembership Type *NewDualReinstated (break in membership)Renewing (no break in membership)Transfer (If applicant is transferring from another club, please fill in the two lines below.)Date of transfer (MM/YYYY)Previous club name and numberMember’s Agreement and Release *Consistent with my desire to take personal responsibility for my conduct, individually and as a member of Sea Dragons Gavel Club, I agree to abide by the principles contained in A Gavelier’s Promise, the Toastmasters International Club Constitution and Standard Bylaws for Gavel Clubs, and Sea Dragons Gavel Club’s policies. I will refrain from any form of discrimination, harassment, bullying, derogatory, illegal, or unethical conduct, and I understand that if I engage in such conduct, I may be responsible for reimbursing Sea Dragons Gavel Club or other clubs or individuals connected with Sea Dragons Gavel Club for any damages, losses, or costs resulting from my conduct. Understanding that Gavel Clubs programs are conducted by volunteers who cannot be effectively screened or supervised by Toastmasters International, I release and discharge Toastmasters International, its clubs, governing bodies, officers, employees, agents, and representatives from any liability for the intentional or negligent acts or omissions of any member or officer of Sea Dragons Gavel Club or other associated clubs, or any officer of Toastmasters International. Should any dispute arise, I expressly agree to resolve all disputes, claims, and charges relating to Toastmasters, districts, clubs, and Gavel Clubs members in accordance with Protocol 3.0: Ethics and Conduct. By submitting this application, I expressly agree to the following:The collection, use, and processing of the personal information I provide to Sea Dragons Gavel Club in this Membership Application for the purposes of club administration and inclusion of my contact information in a members’ directory that will be distributed to members and club officers of Sea Dragons Gavel Club. This also includes the collection, use, and processing of my personal information collected by Sea Dragons Gavel Club through its website and electronic communications.That my information may be accessed and used by Sea Dragons Gavel Club and its club officers.That I will maintain accurate and up-to-date personal contact information by updating my profile with club officers at Sea Dragons Gavel Club. International website: http://www.seadragonsgavel.org. I understand that most of the data requested in this application is necessary for administrative and planning purposes.Occasionally we would like to contact you with details of services, educational updates, and organizational updates. If you consent to us contacting you for this purpose, please check the box below corresponding to acceptable contact methods:MailEmailPhoneIf you would rather not receive non-essential communications from us, please check hereA Gavelier’s Promise *As a member of Toastmasters International and my club, I promiseTo attend club meetings regularlyTo prepare all of my projects to the best of my ability, basing them on the Toastmasters education programTo prepare for and fulfill meeting assignmentsTo provide fellow members with helpful, constructive evaluationsTo help the club maintain the positive, friendly environment necessary for all members to learn and growTo serve my club as an officer when called upon to do soTo treat my fellow club members and our guests with respect and courtesyTo invite guests to club meetings so they can experience the benefits of Gavel Club membership.To adhere to the guidelines and rules for all Toastmasters education and recognition programsTo uphold Toastmasters’ core values of integrity, respect, service, and excellence in all Gavel Clubs activities.Additional InformationSubmit