Membership Application
Complete this form to request membership in the Rotaract Club of Kansas City.
Email address *
Personal Information
Full Name (First M. Last) *
Date of Birth *
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Home Address *
Office Address
Phone Number *
Occupation/ Area of Study *
Membership Information
Area(s) of Interest *
Required
Will you take part in 60% of the club's social and service activities? *
Are you willing to pay member dues? *
Member dues are $100 annually.
Are you a child or grandchild of a Rotarian? *
The Rotary Foundation offers opportunities to Rotaractors (who are not children or grandchildren of Rotarians) for study and travel abroad.
Acknowledgement of Application
I understand and accept the principles of Rotaract as expressed in its purpose and objectives, and agree to comply with and be bound by the "Standard Rotaract Club Constitution", "Rotaract Statement of Policy", and by-laws of the club.
e-Signature (full name) *
Date *
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Submit
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