Part 1 - Name of Student Applying for Rotary Interact Club

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Part 1 - Name of Student Applying for Rotary Interact Club

Please indicate the grade the student(s) will be entering for the 2023-2024 school year. Please include the student's email here; this is the email address we will use for weekly newsletters and important announcements.

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* Indicates required question

Email *

Your email

Student phone number (for texting updates on events)

Your answer

Student Name, Age, gender *

Your answer

What grade of school are you in?

Grade 7

Grade 8

Grade 9

Grade 10

Grade 11

Grade 12

Clear selection

What school do you attend?

Your answer

How did you find out about Rotary Interact?

Your answer

Are you new to Interact?

Yes

No

Clear selection

Next

Clear form

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