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WDM Rotary Membership Application
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Name of Company or Organization
*
Your answer
Address
*
Your answer
Mailing Address (this is where we send your invoices, Rotary magazine)
*
Your answer
Gender
Male
Female
Prefer not to say
Clear selection
Preferred Phone Number (please specify cell/business/other)
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Membership Type & Dues
*
Active: $300 per quarter (all lunches included, $25 is distributed to RI Foundation)
Junior (under 36): $60 per quarter ($20 per lunch attended)
Corporate
Interests/activities to enhance membership application consideration?
Volunteering
Fundraising
Community Involvement
Personal & business growth
Continuing education
Membership
Rotary International
Other:
Are you a transferring (current) Rotarian?
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Yes
No
If yes, name of transferring club and RI # (if known)
Your answer
If yes, date of membership
MM
/
DD
/
YYYY
Who referred you to WDM Rotary Club?
Your answer
Please type your name to signify you agree all the information above is accurate.
*
Your answer
Thank you for your information!
All membership applications are reviewed by the WDM Rotary Board. We'll notify you of approval/rejection via email. If approved, we'll schedule your WDM Rotary Induction date.
A copy of your responses will be emailed to the address you provided.
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