Free Rotary Membership Form

Please fill out the form with your information below.
Name
Email Address
Phone Number
Occupation
Company/Organization Name
Type of Membership
Active Member
Honorary Member
Corporate Member
Have you previously been a member of any Rotary Club?
Please specify club name and location
Areas of Interest in Rotary
Community Service
International Projects
Leadership Development
Public Relations
Are you willing to participate in club activities and meetings regularly?
Consent & Agreement
I confirm that the information provided is accurate. I understand that my membership is subject to approval by the Rotary Club. I agree to abide by the Rotary Club’s principles, ethics, and service commitments.
Name:
Date:
Thank you for your submission!
We appreciate you taking the time to submit.
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