SEATTLE 4 ROTARY MEMBERSHIP APPLICATION
Thank you for submitting your application for membership. Should you have any questions as you proceed, please email fiona@seattlerotary.org

Connecting for Good - Rotarians Inspire Hope
fionaFirst Name *
Last Name *
Nickname or Preferred Name *
Prior Rotary Membership (if applicable)
Why do you want to join Seattle 4 Rotary? *
Date of Birth mm/dd/yyy *
Business/Organization Name *
What product/service does your business/organization provide? *
Current Position/Job Title *
How long have you been with your current company/organization? *
Describe your current role in your business/organization *
Financial Interest in the Company *
Business Address *
Business Email *
Business Phone *
Please list your position immediately prior to your present position *
College or University Attended
Degree
Home Address *
Personal Email *
Home Phone or Cell *
Preferred contact method *
Home/Cell
Business
Phone
Email
Address
Professional or Personal References
List 3 members of the business and professional community with whom you are well acquainted and who can speak to your potential membership in Seattle Rotary. These can be members of Rotary but should NOT include your proposer. Please notifiy your references that someone from the Classification Committee will contact them. You must include:

Name
Email
Phone
Years Known
Reference 1 *
Reference 2 *
Reference 3 *
Community Service Information
Please list any present and past community service activities you have been involved with.

Name of organization
Position you held
Years you were involved (from yyyy to yyyy)
Organization 1
Organization 2
Organization 3
Membership Type
Individual
The traditional Rotary membership with all the privileges, opportunities and responsibilities that come with being a Rotarian. This is our most common membership type.

Corporate
In addition to the benefits of the individual membership, when a corporate member is not able to attend a Wednesday luncheon, any fellow organization colleague can be sent in their stead for meal and attendance purposes - no advance notice, reservation or RSVP is required.

Young Rotary Leader (YRL)
The YRL membership program is for those 35 and under who strive to become leaders in the years ahead. YRLs must demonstrate leadership in their profession, and meet all the qualifications of Rotary membership. YRL pay reduced fees for their first five years of membership.
Membership Type you are applying for: *
Membership Classification
Classifications help members find other members in their own industry, or in a field where they are looking for services through our on-line membership directory. They are a great tool for building your professional network within Rotary. Please choose ONE classification from the options below.
Choose One Classification *
Financial Obligations of Membership
The fees shown are a requirement of membership. The initiation fee, dues and program plan will be billed upon acceptance. Program plan includes lunch for in-person meetings and zoom option for all weekly meetings. The Seattle Rotary Service Foundation (SRSF) and The Rotary Foundation (TRF) annual giving is billed each fall.
July 1, 2021 - July 2022
Billing Information
For your convenience we offer annual or monthly invoicing for membership dues and program plan. If you would like us to cc anyone on your billing email please indicate below. Invoices and statements are sent by email. Please add maildelivery@freshbooks.com to your safe senders list to ensure they are received. Payments are accepted online by credit card or by check. Monthly invoices are sent one month in advance on the first of the month and payment is due by the 25th of the month. Annual invoices are sent on June 1 and cover July 1 - June 30. Initial invoices are pro-rated to the month of acceptance.
I would like to receive by invoicing: *
Please cc the person below on my invoices. Name and Email Required.
The name of my Seattle 4 Rotary member proposer is below and I am aware that they will be contacted regarding my application. *
The name of my Seattle 4 Rotary member seconder is below and I am aware that they will be contacted regarding my application.
I do not have a seconder for my application. I understand that a member of the Classification Committee will contact me directly to review my application with me.
By accepting below I attest that I have read and understand the application, the amounts of required dues and fees (and agree to pay same when invoiced), and the membership expectations. *
Required
Thank you for your application
Applications are submitted to the membership classification committee on the first Tuesday of each month. They are reviewed and passed along to the Board for final approval on the fourth Thursday of each month. Once approved the candidate's name will appear in the weekly newsletter for one week and if no objections are received, the candidate will be welcomed to membership. During this time candidates are invited to attend weekly meetings as a guest.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy