TOASTMASTERS INTERNATIONAL DISTRICT 4
DISTRICT COUNCIL MEETING PROXY

Club Name: _____________________________________ Club No: ________

I hereby appoint________________________________ to vote as my proxy during

the District Council Meeting at the Fall [  ]   Spring [  ]  Conference. (check one)


Signed: ________________________________________________

Office: Club President [  ]  VP Education [  ]  (check one)

Date: ______________________________