Bandey-Hefler Fellowship Exchange Form for US Hosts in 2023

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Dear Fellow Rotarian and Partner:

Fill out this information sheet so that we may be better able to match you with a couple of similar interests.

It will also be passed along to our British guests to provide them with some information about you, their hosts.

Please complete and return this form as soon as possible (no later than 6/1/2023)

We encourage you to provide any additional information on sightseeing places, and suggestions and/or requests for a specific couple you would like to host or anything else helpful to us in making the best possible match-ups.

Questions About the Rotarian

Rotarian Name *

Address (include street address, state, zip) *

City/town *

Email *

Home phone number

Business phone number

Cell phone number(s) *

Rotary club *

Age *

Interests *

Rotary history (length of participation in rotary) *

Rotarian's occupation (previous occupation if retired) *

Biographical information(Rotary projects, organizations, etc.)

Children? (names and ages)

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