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Prospective Member Form

Thank you for your interest in becoming a Rotarian. Rotary International is an association of individual clubs that operate autonomously. Membership is extremely important to us, and we are always eager to hear from individuals interested in our mission and joining our Rotary Club.

Our universal premise is that each club's membership constitutes an accurate representation of the business and professional population within the community served. Membership in a Rotary club requires an invitation and sponsorship by a member of the club as well as an available business or professional classification. Sometimes an individual cannot be invited or sponsored for membership.

Please provide us with your name and contact information. We will forward it to the appropriate person in our club. Any comments are appreciated.

Note: All fields are required for submission.

First Name:

Last Name:

Address:

City:

State:

Zip:

Country:

Phone:

E-mail address:

Profession:
How did you hear about Rotary?
How did you hear about our Rotary Web site?

Comments: