Individual Membership Proposal
Name
First Name
Last Name
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred E-mail Address
example@example.com
Preferred Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Birthday
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Number of years in Princeton
Spouse/Partner Name
First Name
Last Name
Wedding Anniversary
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Business Name
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Title or Position
Nature of Business or Profession
Community Activities
Have you ever been a Rotarian? If so, when and where?
Are you aware of and agree to the financial requirements of being a Rotarian?
Does your company agree to collectively attend at least 50% of regular meetings or other Rotary events?
Are you willing to commit to serving on club committees?
Signature of proposed lead member:
Date of Signature
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Part 2: To be completed by the proposer or sponsor
How long have you known the proposed member and in what capacity?
Describe the proposed member's character and habits that you believe will make them a good addition to Princeton Rotary?
Submit
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