Membership Application
for the Rotary Club of Erie Colorado
Share the name of the person that invited you to join the Rotary, or how you learned about our club.
*
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What type of membership interests you?
*
Individual Membership $300 annual dues
Individual and +1 (spouse/partner): 2 active members $500 annual dues
Corporate Membership: up to 2 active members $500 annual dues
What motivated you to apply for membership to our Rotary Club?
*
Fellowship and community service
Use my talents to support and grow the club mission
Rotary Principals of Truth, Fairness, Goodwill, and Friendship
Broadening my network with people who share my drive to give back
What is your profession? If retired, what primary skill/talent would you like to share within the club?
*
What community service or volunteer experience do you have?
*
Your birthdate
-
Month
-
Day
Year
Date
Are you a former Rotarian?
*
Yes
No
What is your Rotary ID Number? (on MyRotary.org view MY PROFILE) If you don't know it, tell us that.
Please verify that you are human
*
Submit
Should be Empty: