Becoming a Member
 
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Before completing the membership application, please see our Frequently Asked Questions about membership.

Personal Information
Full Name:


Mailing Address (City, Province and Postal Code):


Telephone (home):

Telephone (mobile):

Fax:


Email (if you maintain multiple accounts, list the most commonly used address):


Date of Birth:

Partner/Spouse:

Anniversary:

Professional Information

Business/Profession:

Title:

Business Name and Address (City, Province and Postal Code):

 Telephone (office):

 

Former and Transferring Rotarians:

RI Member Number:


Please list which clubs you have been a member of and when:


Rotarian Proposing Membership:

Name of Rotarian (if one):