Birdcage New Member Profile Sheet Personal Data Name: Email: Phone Number: Occupation & Employer: Interests: Name of Sponsor: Name of Mentor: If you do not have a Mentor, would you like us to arrange one for you? (Please fill out the enclosed Mentor Request Form.) Communication and Leadership Goals What objectives do you hope to accomplish as a member of this Club? Is public speaking a requirement of your job or profession? How would you describe your current skill level as a speaker? (On a scale of 1 to 5, 1 being never done it to 5 being excellent) Do you have any specific fears relative to public speaking? (Examples could be: Shortness of breath, perspiration, anxiety, lump in throat, dry mouth, forget your words, etc.) Why did you choose to join Toastmasters Club? What can the Club do to help you accomplish your goals? Thank you for taking the time to fill this in for the Club!