PolioPlus Society Registration

District 6440 PolioPlus Society Registration & Pledge
Name

First Name Last Name
Email
example@example.com
Club
Do you make the following PolioPlus Pledge? *

Yes No
The PolioPlus Society Pledge

Until the world is certified polio-free, I pledge to donate $100 every Rotary Year to the Rotary Foundation PolioPlus Fund.

I understand that if I satisfy the first year of my pledge by June 30, 2022, I will become a Charter Member of the District 6440 PolioPlus Society. I understand that I will receive Paul Harris Fellow Recognition Points for my donations to the Polio Fund.

With the Gates Foundation match, each $100 will protect 99 children from polio. I pledge to do my part to deliver on Rotary's promise of a polio free world!
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