Membership Proposal form Part A (to be completed by proposer and returned to the club secretary) I propose: Title: Full name: Mailing address: Telephone (including country/city or area codes) Fax (including country/city or area codes) Residence: Business: Cellular/Other: q q Preferred e-mail address: Residence Business Proposed classification: If rejoining or a former Rotarian, list most recent club information: Previous club name: Dates: Previous Rotary membership ID: From To q q Recent Rotarian (one year or less): Yes No If an RI program participant or Foundation alumnus/a, list program(s) and date(s): Activities that would enhance consideration as a Rotarian: Proposer’s Signature Date
Membership Proposal form Part A (to be completed by proposer and returned to the club secretary) I propose: Title: Full name: Mailing address: Telephone (including country/city or area codes) Fax (including country/city or area codes) Residence: Business: Cellular/Other: Preferred e-mail address: q Residence q Business Proposed classification: If rejoining or a former Rotarian, list most recent club information: Previous club name: Dates: Previous Rotary membership ID: From To Recent Rotarian (one year or less): q Yes q No If an RI program participant or Foundation alumnus/a, list program(s) and date(s): Activities that would enhance consideration as a Rotarian: Proposer’s Signature Date
How%20to%20Propose%20New%20Member%20Brochure.docx