Sunrise Rotary Membership Application
Welcome! We are excited to learn about you as a potential member of Sunrise Rotary. Tell us a little about yourself. This form will be submitted to the Sunrise Rotary Membership Chair, who will contact you to discuss your application
Name *
Email *
Birth Date *
Home Phone *
Mobile *
Home Address *
Business / Employer Name *
Position / Title / Description
Business Address
Business Phone
Spouse or Significant Other Name
Children Name(s) and Ages
Personal interests, hobbies, professional/charitable activities and community involvement:
Why do you want to join Rotary? *
How did you hear about Sunrise Rotary?
List your Rotary sponsor, if you have one.
Have you previously been a member of Rotary?
Clear selection
Which committee(s) would you be interested in learning more about? Please select all that interest you.
The Four-Way Test is a nonpartisan and nonsectarian ethical guide for Rotarians to use for their personal and professional relationships. As a member I commit to the best of my abilities to: *
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I agree to pay a one-time admission fee of $50, annual dues of either: $800 (with breakfast) or $400 (without breakfast) in accordance with the bylaws of the club. I hereby give permission to the club to publish my name and proposed classification to its members. * *
Type of membership requested? *
Membership Due Payment Schedule *
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