Trustee Candidate Application

TO BE ELECTED IN 2027: Region 1 (Divisions 14, 15, 16) Term 2027-2030

TO BE ELECTED IN 2027: Region 4 (Divisions 1, 6) Term 2027-2030

Candidate Application Filing Open Jan. 2 through March 1.

Part 1 – To be filled out by the candidate. Part 2 (below) – To be filled out by club president.

Regional Trustee Candidate Application 2027

Trustee Candidate Filing 2027 – Applications accepted Jan. 2 – March 1

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Region #(Required)

Division #(Required)

Kiwanis Club of:(Required)

If belong to multiple clubs, please list your (one) primary club

Club Key Number – K-_____(Required)

Name(Required)

First Last

Member ID #(Required)

Lt. Governer Service – List Divisions & Years(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country

(Please include both mailing address, and street address if mailing address is a PO Box)

Phone(Required)

Email(Required)

Business/Profession:(Required)

Spouse's Name

Is spouse also a Kiwanian

Yes

No

PLEASE NOTE: Some of the information you provide will appear in International and district directories. This information also may be listed on Kiwanis Web sites.(Required)

Check here to indicate you have read this note.

I have read the Regional Trustee job description in the District Bylaws and reviewed responsibilites in Policy and Procedures and am willing and able to perform said duties.(Required)

Check here to indicate you have read,

Signature(Required)

Date(Required)

My primary club president's name is(Required)

My club president is aware that he/she must submit the club endorsement certification to complete this application and that the endorsement must be submitted by the deadline.(Required)

Yes

(Club endorsement certification form can be found below on this page)

Please attach current photo of you(Required)

Accepted file types: jpg, jpeg, png, gif.

(low resolution/small file size photos may not be usable)

Candidate Bio (up to 200 words)(Required)

(Examples of items to include: years in Kiwanis, club and district positions held, notable accomplishments, service or committee work, etc.)

Submit Save & Continue

Part 2 Club Endorsement – Must be submitted to complete the application.

Regional Trustee Candidate Application – Club Endorsement

This form is to be completed by president of candidate’s primary club and submitted by filing deadline. Trustee candidate application will not be complete until this endorsement is submitted.

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Name of trustee candidate applicant(Required)

Name of Club:(Required)

Club ID # K-(Required)

Name of club president:(Required)

As president of the primary Kiwanis Club of the trustee candidate applicant, I certify that our member is in good standing and has been endorsed by the club's board and/or membership for the office of Regional Trustee.(Required)

Yes

Date of endorsement vote by board or membership:(Required)

Vote by

Club Board

Club Membership

Signature(Required)

Date(Required)

Date

Submit