District 5 New Club Sponsor/Mentor Interests Survey
RequiredRequired Question(s)
Required 1.
Please enter the information indicated below.

First Name:
Last Name:
Email Address:
emailaddress@xyz.com
Club Name:
Phone #:

Required 2.

Educational Awards

CC
ACB/ACS/ACG
CL
ALB/ALS
DTM
Other  
  • Comment:

  • 500 characters left.
Required 3.
Your availability
Weekday morning
Weekday lunch
Weekday evening
Saturdays
Sundays
Other  
  • Comment:

  • 500 characters left.
Required 4.

Your location - If your location is time-dependent, please spell out the options.  We'd try to match to minimize the transportation time. 

 

1000 characters left.
Required 5.

Have you served as a club sponsor/mentor/coach before?

Yes
No
Other  
  • Comment:

  • 500 characters left.
6.
What would you like to accomplish/learn by serving as a new club sponsor/mentor?
 

1000 characters left.
Thank you for your interests in serving as a new club sponsor/mentor.  You will be guided to the new club launch procedure page.