Rotary Sacramento Membership Application
Your name and proposed classification will be published in our weekly newsletter, The Pulse. You will then be contacted via email scheduled for an orientation session and induction date. Please allow between 2 and 4 weeks for the membership processing and approval.
Email *
First Name: *
Middle Name:
Last Name: *
Date of Birth (Information kept private) *
MM
/
DD
/
YYYY
Badge Name *
Sponsors
New Members must identify two Rotary Club of Sacramento members who will serve as sponsor and mentor. If you are unable to identify two sponsors the membership committee will assist you this process.
Membership Sponsor #1 (staff will print for signatures) *
Sponsor #1 Signature
Membership Sponsor #2
Sponsor #2 Signature (staff will print for signatures)
Business Information
Company Name: *
Position/Title *
Business Type: *
Business Mailing Address:
Business Phone:
Business Email:
Business Website:
Residence Information
Mailing Address: *
Phone: *
Mobile: *
Personal Email: *
Preferred Mailing Address *
Preferred Phone: *
Preferred Email Address: *
Rotary Service
Explanation of any past Rotary service.
Previous Rotary Club(s)
Prior Rotary Office(s) Held:
Are you a Paul Harris Fellow?
Clear selection
Family & Hobbies
Partners Name:
Musical Instruments Played
Languages Spoken/Written
Other Hobbies/Interests (sports, theatre, etc.)
Education
Educational Institution(s) and Degree(s)
Military Service
At Rotary we honor our service members and veterans.
Military Branch of Service
Years Served:
Membership Levels
Individual
Membership belongs to the individual
Initiation Fee (one-time) $250
Dues: $1695 per year (billed quarterly)
Dues are inclusive of fees for weekly luncheons, Happy Hours, and Firesides. All other events are invoiced separately
Transferring/Reinstating Members - Reduced Initiation Fee of $100
Under 40
Membership belongs to the individual
Initiation Fee (one-time) $100
Dues: $566 per year (billed quarterly)
Dues do not include fees for weekly luncheons, Happy Hours, and Firesides. All events will be invoiced separately.

Corporate/Non-Profit
Corporate Entity retains the membership and can replace members upon request.
Initiation Fee (one-time) $250 per person
Dues: $850; plus $500 for 20 prepaid meals per person (billed annually)
Dues are inclusive of up to 20 weekly luncheons, Happy Hours, and Firesides. All other events are invoiced separately.
Which membership type best describes you? *
Professional Headshot
Please email your professional headshot in high resolution format to info@rotarysacramento.com. This is for the online directory. If you do not have a headshot one can be taken by a fellow Rotarian at a discounted rate. Contact the Rotary office for details, info@rotarysacramento.com.
Provide One-time Initiation Fee Payment
Please identify how you would like to provide payment for your initiation fees.
Payment Options
Clear selection
I am interested in automatic payments and would like accounting to contact me.
Clear selection
Applicant Signature (staff will print for your signature)
Rotary Club of Sacramento
P.O Box 2528, Fair Oaks, CA. 95628/ 916.929.2992/info@rotarysacramento.com
Rotary Club of Sacramento Foundation 501(c)3 Tax ID#23-7117223
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy