Brighton & Hove Soiree Rotary Club Membership Proposal Form

Part A To be completed by the person wishing to be a member
Sign in to Google to save your progress. Learn more
Email *
Full Name *
Personal Telephone Number *
Business Telephone Number
Mobile Telephone Number *
Full Address including Post Code *
Partner / Significant Other Name *

Date of Birth:

MM
/
DD
/
YYYY
Gender
Clear selection
Previous Club & Rotary ID Number (if known)

Please note: current members of another club should not terminate in their existing club until they have been accepted into the new club and then both club secretaries liaise regarding termination and start dates to give consecutive membership history.

Current/ Previous Work Position
 *
What languages do you speak enough for a good conversation?
 *
How did you hear of Rotary? *
Part B Your Agreements & Signature

I, the undersigned, hereby consent to this proposal for membership in the Rotary club being examined in accordance with the constitutional procedures of Rotary International in Great Britain and Ireland. 

I accept that enquiries will need to be made about me. 

I am willing to meet members of the club to provide further information and to learn more of the particular obligations and privileges of membership. 

I understand that if I wish this proposal to be considered further the above particulars will be circulated to all current members, but if at any time I wish this proposal to be withdrawn no further action will be taken. 

I also understand that in the event of there being objections my application may not be successful, and that reasons for not inviting me to membership will not be given. 

If invited into membership I agree to accept and be bound by the Constitution and By-laws of the Rotary Club for the time being in force.

By submitting this proposal below, I agree to abide by Rotary's Guiding Principles and The Four Way Test and Rotary Code of Conduct.

Please note that by becoming a member of a Rotary club, for certain Rotary activities, where legally required, you will be subject to Disclosure and Barring Service (DBS) checks.

 *
Should my application be successful I agree to have a soireerotaryclub.com email address and use this for all club business  including club administration and communication. *
I agree, should may application be successful, to adhere with the Club's Privacy Policy.
 *
Proposed member's Signature. By typing your name below and submitting this proposal you agree to apply to become a member of the Brighton & Hove Soiree Rotary Club and agree with the terms set out above. Please type your full name here. *

Rotary GB&I Privacy Notice

Rotary International in Great Britain and Ireland promise to respect the confidentiality of any personal data you share with us, or that we have access to through Rotary International (RI), to keep it safe, and we will always take every effort to protect your privacy. We pride ourselves on our honesty and openness and will always be clear how, when and why we collect and process your information; we promise we will never do anything with your details that you wouldn’t reasonably expect to allow us to manage your membership and provide the services you are entitled to. It is expected that club and district officers may also process member personal data on behalf of Rotary GB&I and RI and they too will also be bound by the Rotary GB&I privacy notice. Full privacy notices are available online for Rotary GB&I and RI.

Once your membership record has been set up, club members within Rotary GB&I are encouraged to review and reset, if required, their privacy levels within the Data Management System (DMS). Privacy levels range from 1 (lowest level of sharing data) to 5 (highest level of sharing data). New members are entered on the DMS with a default level of 5. A full explanation of the various privacy levels is explained in the ‘privacy’ section of the DMS for you to select your preferred option.
Proposer's Signature. This form will be saved as a PDF within the Club's filing system and copy sent to your proposer. They will reply back by email to confirm that they are the proposer of the potential new member and this email will be stored with the proposal form.
Today's Date *
MM
/
DD
/
YYYY
Part C Items you need to send us

a) Please write a short resume of your background and interests. This should be more than 200 words but no more than 500 words.
 *
Part C Items you need to send us

b) Please share your reasons why you wish to join Rotary. This should be more than 200 words but no more than 500 words.
 *
c) Pleaase send a photo of yourself, preferably square to secretary@soireerotaryclub.com
 *
Thank you for your application. Please immediately send a good quality head and shoulders picture of yourself to secretary@soireerotaryclub.com. 

You will hear back within 14 days and probably a lot sooner! 
Please include the name and contact details of a referee that we can contact. This person may be a work colleague or friend, but in both cases they should havew known you for more than THREE years. Please include full name, postal address, email, mobile and their relationship to you. *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms