Rotary Club Membership Application Form

Rotary Club of Half Moon Bay

Membership Application
Complete the form below to apply to membership in our Rotary Club.

Name

First NameLast Name

E-mail

Home Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Employer:

Occupation:

Work Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Why are you interested in joining our Rotary Club?

Describe your past involvement with the community and service?

Personal biography about your professional experience:

Professional offices held (present or past):

Professional service awards:

Hobbies, special interests, favorite quotes or words you live by:

Are you a past member of a Rotary Club?

YesNo

If yes, name of club and location:

Are you a past participant in a Rotary International or Rotary Foundation program?

YesNo

If yes, which program and when?

Are you applying for an Organizational Membership?

YesNo

If yes, please provide names, titles and emails of other associates who will represent your organization.

Birthday (Month/Day)

Shirt Size:

SMLXL

I understand that it will be my duty, if elected, to exemplify the Object of Rotary in all my daily contacts and activities and to abide by the constitution and bylaws of the club. (Please see the new member orientation materials.) I understand that there is a one-time new member initiation fee of $125 plus monthly dues. (Check with your President.)

The initiation fee includes a donation of $25 to Rotary International for the "Every Rotarian Every Year" campaign. Rotarians are encouraged to donate $200 per year to Rotary International (that can be set up on automatic deposit of $17 per month.)

Please confirm that you understand the privileges and responsibilities associated with Rotary membership, and agree to promote the ideals of Rotary and comply with the requirements of the Rotary Club.

YesNo

Once you submit your application, we will contact you shortly to complete your membership application.

Questions? Contact HMB.Rotary.President@gmail.com

Thank you!