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Altrusa Referral Form

Membership is everyone’s responsibility. Through our connections - both near and far - we have the opportunity to grow Altrusa, share its mission with others, and extend our Altrusa journey in meaningful ways. It is through referrals that we can expand Altrusa beyond our own clubs—and that’s when you become an Altrusa Ambassador!

Do you know someone outside your club who would make a great Altrusan for another club (inside or outside of your District)? By referring friends, colleagues, and acquaintances in other communities, you not only help grow Altrusa—you also have the opportunity to be recognized as an Altrusa Ambassador.

Has an Altrusa member recently moved to a new area?   Altrusa values every member, and we never want to lose someone simply because they have relocated. When a member moves, we want to stay connected—expressing our appreciation for their membership and offering options to help them remain engaged with Altrusa.

When you refer that individual to another club (a club other than your own) AND they become an Altrusa member, you can earn the distinction of being an Altrusa Ambassador!

Send us your referral information and our team will follow up with your referral or former member to help them connect and continue their Altrusa journey.

Please take a moment to complete the information below to:

  • Refer a potential new member to another club
  • Share information about a member who has relocated

There are many ways to make an impact… and this is one of them!  it is a Win-Win!

Thank you for taking the time to submit your Altrusa Referral.

Questions? Contact us at DistrictNineAltrusa@gmail.com
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This form is for (select one) *
Your Name *
Your Phone Number
Your Email *
Name of relocating member or new member lead. *
Address of relocating member or new member lead.
City and state of relocating member or new member lead.
Cell phone of relocating member or new member lead.
Email of relocating member or new member lead.
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