Membership Inquiry Form
* Required
Company/Organization
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Name
*
Your answer
Position/Title
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Sponsoring Rotarian
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I am...
*
a potential new Rotarian
a transferring Rotarian
interested in more Information about Rotary
Other:
If you are interested in transferring your membership, please list the Rotary club(s) to which you previously belonged starting with the most recent.
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Contact Phone Number
*
xxx.xxx.xxxx
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Contact Email
*
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Are you under 35?
Yes
No, but you're only as old as you feel.
Additional Comments?
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