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Eastern Canada and the Caribbean District

CLE Trainer Application Form

CLE Trainer Application

Section 1

Division – Please enter your division number(Required)

Please enter your division number

Name

First Last

Phone

Email(Required)

Section 2

Language

I speak and write English fluently

I speak and write French fluently

What is your current profession or retired profession?

How many years have you been a member of Kiwanis

Number of years only

What is the highest position in Kiwanis International which you have served?

Club President

Lieutenant Governor

Governor

District Trustee

International Trustee

Choose only one

Have you previously served as a Certified Club Leadership Education Trainer?

YES

If YES above, , how many three-year terms did you serve?

Describe your experience facilitating adult learning groups within Kiwanis.

Describe your experience facilitating adult learning groups outside of Kiwanis

What is it about the position of Club Leadership Education Trainer that interests you?

Section 3

In this section please indicate your response by clicking one of the boxes.

I am willing to participate in my district's Certified Instructor orientation process.

YES

I am willing to make a three-year commitment to provide Club Leadership Education to incoming leaders in my district.

YES

I am available to help division and district leaders plan other types of education programs.

YES

I agree to facilitate the CLE Training Program and Curriculum as directed by Kiwanis International.

YES

I agree to work with the Lieutenant Governor-elect of my Division as a Training Partner in the delivery of Club Leadership Education session in my Division

YES

Consent

I agree to the commitments listed above

Thank You for your application.

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