Application for Rotary Club Washington Global (RCWG) Membership
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 Adrien Kay Lopez  ( and copying 2023/24 Club President Sarah Nadiv ( 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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I agree to the RCWG membership conditions. *
Title (Mr., Mrs., Dr., etc.)
First Name *
Last Name *
Clear selection
Date of Birth
Are you a Rotarian or former Rotarian? *
If a Rotarian/former Rotarian, provide RI ID number.
Name of former club (last club if multiple)
Are you a Rotary alumni (e.g., Interactor, Rotaractor, Peace Fellow, Ambassadorial Scholar)
E-mail address *
Preferred phone number *
Alternate phone (if applicable)
Preferred Mailing Address  (not your email address, but a physical mailing address) *
If accepted as a RCWG club member, can we point to (and grab your photo) from your Linkedin profile (if you have one)?
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Please indicate if the address is residential, business, or other.
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Job Title *
Name of business or organization
Classification (type of job/profession)
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Briefly tell us how you heard about our club. *
Please tell us about yourself (short bio) *
Are you interesting in one or more service activities in particular? If so, please explain.
Are you interested in  making a short presentation on your work or passion at a club meeting? If so, please indicate the topic.
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Do you have any comments or suggestions on priorities for RCWG?
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