ROAM 5790 Membership Interest Form
Rotary District 5790 is in the process of forming an online e-Club. This form is intended to gather information from prospective members or those that wish to know more about participating in a Rotary online e-Club. We will contact all prospective members and inviting them to participate in the club formation process.
Name *
Email *
Are you currently a Rotary Member? *
Address information
Have you been a Rotary member in the past? *
Would you be interested joining a Rotary e-Club? *
Would you be interested in serving in a leadership capacity to start an e-Club in District 5790?
Please provide your contact information
Street Address *
1 point
City *
1 point
State *
1 point
Country *
1 point
Cell Phone Number *
1 point
Home Phone Number *
1 point
Office Phone Number *
1 point
Preferred method of communication *
1 point
What questions do you have about being a member of a Rotary e-Club
Recognizing that participation in a Service Project in the area near where you live is the ideal for all Rotary members, efforts will be made to share local service project information with our members. How far would you be willing to drive to participate in a service project?
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service