Rotary e-Club of Houston - Membership Form
Former or current Rotarians must be in good financial standing with their former or current club to be accepted in membership. Current Rotarians requesting consideration for membership in the e-Club must notify their club secretary of their intentions to join. Rotarians from other clubs seeking transference to our club must first be terminated from their club and from Rotary International database in order to be added as a member in our club.
Email address *
Full Name *
Your answer
Work Email (if preferred )
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Mobile Phone number: *
Your answer
Address (Street, City, State and Zip Code) *
Your answer
Business or Profession (even if retired) *
Your answer
Work Address
Your answer
Work or Home Phone, if preferred
Your answer
Preferred communication *
Please complete this if you are a Rotarian *
If previously a member of Rotary International, please add your Membership # (on cover of The Rotarian magazine or contact your club's secretary to ask)
Your answer
Club Name & Year inducted:
Your answer
When Terminated:
Your answer
Positions held at club level:
Your answer
Position held at District level:
Your answer
What would you like to contribute to Rotary?
Why would you like to join us? *
Your answer
What are your favorite spare time activities/hobbies? *
Your answer
Do you have expertise that you would like to share? Here are some examples: *
Required
Who recommended you to our club? Or how did you find out about Rotary E-Club of Houston?
Person's Name:
Members have the responsibility to pay membership dues on time ($150 yearly), and to read our newsletter and submit the online attendance form twice a month. We expect members to be active in our club in serving humanity as a team or as individuals. Do you accept these responsibilities? *
Thank you for your responses and congratulations on this big step to help change the world to a better place. Our club's Membership Chair will contact you shortly.
A copy of your responses will be emailed to the address you provided.
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