Membership Application
Rotary Club of Eastern Independence.
Welcome to the Rotary Club of Eastern Independence! We are honored that you have chosen to request membership to our club. Please complete the application below and select "submit".
Full Name *
Your answer
Name of Sponsor *
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Home Address *
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Work Address *
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Please let us know where you prefer to receive Rotary related correspondence *
Work Email *
Your answer
Home Email
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Please tell us where you prefer to receive Rotary related email *
Let us know your requested industry classification
Example: Loan officer, Business Law, HealthCare, Business Development, Education, Marketing
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