Taipei Leadership Village Rotary Club Membership Application Form

Taipei Leadership Village Rotary Club Membership Application

台北達仁扶輪社會員申請表格
Complete the form below to apply to membership in our Rotary Club.

請填寫完以下表格，以利會員資格審查，謝謝。

Who is your Rotarian sponsor or reference?/請填寫介紹人姓名。

Nickname/申請人暱稱

First NameLast Name

Mandarin Name/申請人中文姓名

First NameLast Name

Passport Name/申請人姓名羅馬拼音

First Name/名字Last Name/姓氏

Please upload a photo of yours./請上傳一張您的照片。

Company name/ 公司名稱

Job title/職位名稱

E-mail/聯絡電子郵件

Home Phone Number/家用電話

Area Code/區碼Phone Number/號碼

Work Phone Number/工作電話

Area Code／區碼Phone Number／號碼

Mobile Phone Number/手機號碼

Area Code／區碼Phone Number／號碼

Postal Address/通信地址

Street Address／地址

Street Address Line 2

City／城市State / Province

Zip Code / 郵遞區號Country/國家

Birth Date/出生年月日

MonthDayYear

Are you a past member of a Rotary Club? 您過去曾為扶輪社員嗎？

Please upload your ID for verification/ 請上傳身分證正面或是居留證正面影本以利建檔

Browse Files

Please upload your ID for verification/ 請上傳身分證反面或是居留證影本反面以利建檔

Browse Files

If yes, name of club and location/如果有，請寫出地區及社名

若無，請填寫「無」。

Are you a past participants in Rotary program or affiliate groups (ie. Rotaract/ interact, RYE, etc.) ? ?／請問您曾經參與過國際扶輪之計畫或是相關團體（如：扶青團／扶少團／青少年交換／新世代交換計畫）嗎？

If yes, which program and when?　如果有，請說明是哪項計畫。

若無，請填寫「無」。

Describe your vision in joining our Rotary Club?/請問您想加入扶輪社的願景。

What kind of community service(s) you are interested?/請問您對於哪項扶輪計畫有興趣？

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

Thank you!

謝謝您的填寫，本社理事會將會盡快完成資料審查，並通知您審查結果。