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[Cal Rotaract] Fall 2019 Membership Application
Thank you for your interest in Cal Rotaract! Please fill out this form before submitting your membership dues. In order to make sure that we get your membership dues, please turn them in within one week of submitting this application.

Benefits of Paid Membership:
- Participate in our Family System, where you can join a family and bond with other members!
- Have the opportunity to network with Rotarians through our Rotary mentorship program
- Membership End of the Semester Recognition
- We will be tracking your activity throughout the semester using our point system.
- After accumulating a certain number of points, you will be eligible to receive prizes at the end of the semester.
- Prizes include: Cal Rotaract Lanyard, "Toothpick Holder," and Hall of Fame with free lifetime membership.
Basically, in the end, your membership dues will be going back to you and the service we do!

You can upgrade your membership at anytime if you want to become a paid membership later on in the semester.
Please email if you forgot how many semesters of membership you have left.

Please refer to if you would like more information about becoming a member. You can also email any inquiries to

Due Date: NONE!! You can apply at ANY time this semester, whether in the first month or the last. It's never too late to apply :)
Email address *
First Name *
Your answer
Middle Name
Your answer
Last Name *
Your answer
Phone number *
Your answer
Birthday *
(Just because we like to celebrate birthdays in our club! :))
Year *
Expected Graduation Date (Semester and Year) *
i.e. Fall 2019, Spring 2022, etc.
Your answer
Student ID Number *
Your answer
Major or Intended Major *
Your answer
Are you on our newsletter mailing list? *
We'll send you our bimonthly newsletter to keep you up-to-date on upcoming Rotaract socials and service events. You can always opt out of the mailing list later if you would like!
Are you a new or returning member? *
You are considered a returning member if you have been a part of Cal Rotaract in previous semesters.
How did you hear about us? *
[Check all that apply]
Do you have a FB account? *
We communicate our events and news through our FB account! In addition, many group chats will be created through FB for service events, committees, the family system, and etc.! (If you don't have FB though, don't worry! The newsletter & website are great ways to get access to updated info, and your committee leads / family heads will find a way to communicate with you :)) JOIN OUR GROUP HERE:
Link to your FB profile if you have one.
Your answer
Photo permission? *
Do you grant Cal Rotaract to use your photographs for promotional/showcasing purposes? Note: In Cal Rotaract, we love to document our events and set up photo-booths for our members! This permission allows us to post the pictures we take up on our Facebook page and website so you can look back on the wonderful memories you've created with us! We may occasionally use these images for promotional materials, such as informational fliers about Cal Rotaract. We use these photographs with discretion and responsibility, and the vast majority of our members have no problem granting us permission. If you have any questions, please send us an e-mail at! Thank you!
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