Part 1: New Member Proposal

This is Part 1 of a two-part form. This part should be filled out entirely and signed by the sponsoring member. Upon completion, the form should be given to the club secretary. The secretary will notify the club board of directors and will post the proposed member's name at weekly club meeting for two weeks. Upon approval, Part 2 will be filled out by the approved member.

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Your Name(Required)

First Last

Occupation(Required)

Position(Required)

Nature of Business(Required)

Business Name(Required)

Business Address(Required)

Street Address Address Line 2 City ZIP Code

Your Address(Required)

Street Address Address Line 2 City ZIP Code

Business Phone No.(Required)

Personal Phone No.(Required)

Business Email(Required)

Personal Email(Required)

Why does candidate have potential for Rotary Service?(Required)

Sponsor's Name(Required)

Date(Required)

Sponsor Email(Required)