Thank you for your interest in Club Leadership Education. This application will be reviewed by the Nebraska-Iowa District governor, governor elect and Club Leadership Education Committee. Upon review and acceptance, you will be contacted with additional information. 

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* Name:

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* Kiwanis Member Number:

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* Club Name:

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* Email:

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* Phone Number:

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* I am applying for CLE trainer...

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* I am willing to participate in Nebraska-Iowa District’s Certified Instructor orientation or pre-CLE session planning.

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* I am willing to make a three-year commitment to the CLE program.

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* I am willing to facilitate education/training for (check all that apply)

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* I am willing to offer training sessions that are (check all that apply)

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* For in person training, I am willing to travel (Travel reimbursement is available from the district.)

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* I am available to help division and district leaders plan other types of education programs. (Such as Club Leadership Chats or education programs at conventions)

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* I agree to use material provided and facilitate training as required by Kiwanis International and Nebraska-Iowa District.

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* I agree to participate in any evaluation process for certified instructors.

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* Number of years in Kiwanis:

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* Please list leadership or officer roles (current or past) in club, division, region or district:

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* Other information you would like the district to know about your application:

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