CORPORATE/NON-Profit Rotary Club Membership Application Form

Non-Profit and Corporate Membership Application
Complete the form below to apply to membership in our Rotary Club.

What is the name of the organization?

Who is your Rotarian sponsor or reference?

Name of Primary Contact for the organization:

First NameLast Name

Work E-mail

Secondary E-mail

example@example.com

Office Phone Number:

Area CodePhone Number

Secondary Phone Number:

Area CodePhone Number

Mobile Phone Number:

Area CodePhone Number

Office Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Secondary Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Send Rotary Correspondences to

Why is your organization interested in joining our Rotary Club?

Describe your organization's past involvement with the community and service?

Was your organization a Rotary Club member in the past?

If yes, name of club and location:

Please provide names, titles and emails of other associates who will represent your organization at Rotary meetings and events.

To understand the rights, privledgesa and responsibilities of membership and the operation of our club, be sure to review our Frequently Asked Questions for prospective members and new members.

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.

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

Thank you!