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Global Passport Membership Inquiry

Thank you for your interest in becoming a Rotarian and joining our network of dedicated volunteers. We're always happy to hear from individuals interested in our mission. Impact starts with our members - people like you, who want to be part of making the world a better place. With your help, we can make an even greater difference in our communities anywhere in the world.
Name *

First Name Last Name
Address *

Street Address

Country

City State / Province

Postal / Zip Code
Email *
example@example.com
Phone Number *

Country Code Area Code Phone Number
Date of Birth (Optiopnal)

Year Month Day
DOB
Are you a Rotary Alumni (RYE, GSE, Ambassadorial Scholar, Peace Fellow, Interact, Rotaract)? *

Yes No
If yes, please indicate which program
Are you a current or past member of a Rotary club?
Yes No*
If yes, please enter:
Club Name
RI Number
Rotarian in good standing
   Yes   No
If you checked yes to either option above, please elaborate on your past involvement with Rotary.
How did you hear about our Club? *
Did someone recommend you, if so who?
Your Occupation *
I consent to the collection, storage, and use of my information as described in this Privacy Policy. I understand that I may receive emails, and can opt out at any time *
Should be Empty:

Global Passport Membership Inquiry