Rotary Alumni Data Form
Thanks for providing this information to update the Rotary Alumni database.
By completing this form you consent to the disclosure of this information to Rotary clubs and District committees in New Zealand and overseas for Rotary purposes only.
Surname at time of Rotary program (if different from above)
Date of Birth
Rotary Status (choose those which apply)
Current Rotaractor / Interacter
Past Rotaractor / Interactor
Rotary Program (choose those which apply)
Rotary Youth Exchange (IYE)
Rotary Youth Leadership Award (RYLA)
Rotary Peace Scholar
Grants for University Teachers
Group Study Exchange (members & leaders)
Vocational Training Team (members & leaders)
For Youth Exchange - note country / district hosting you
For scholarships - note institution, course & country of study
For Rotaract or Interact - note club name and district / country
Program Year (for each program, if more than one)
Program start and end dates (for each program, if more than one) - where you can remember. At least the year is helpful.
Sponsor Club (for each program, if more than one)
Current residential address (incl postcode)
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