Membership Form
Thank you for your interest in joining our club. To apply for membership, please fill out this form and send a CV to RCWG Membership Chair Manuela Mot ( copying 2022/23 Club President Anthony Bloome ( Please note the following membership dues. If your application is accepted, you hereby agree to pay to the club $100 upon joining independent of when you join in the calendar year. Thereafter, you will be billed $250 per year in two installments: in June ($125) for July-December and in December ($125) for January-June. Reduced dues of $200 per year are available for members below 35 years of age and for spouses/partners of existing members. The club may change its dues in the future if the board so decides. Continued membership is contingent on being up-to-date on dues. Please type your initials in the box below to indicate your agreement.
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Name and last name *
Date of Birth
Profession And Company Name *
Email *
Phone *
Complete Address, City, Zip, Country *
Are you a Rotarian? From which Club?  *
Do you know your Rotarian number?
Include a brief bio *
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