Detroit Lakes Noon Rotary Club #1394 Membership Proposal Form
This form goes directly to the Noon Rotary Board. Either the proposed member or the proposing member can fill out this application.
Membership Dues/Meals
(Club Dues) $75 Quarter (Meals @12ea) $144/Quarter = (Total w/ Meals) $219/Quarter
Proposed Member [Full Name]
Address
Address
Street Address Line 2
City, State ZIP
State / Province
Postal / Zip Code
Preferred Phone Number (Group SMS)
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Date of Birth
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Employer/Position
Membership
Membership
Active Honorary
Type:
If active, Proposed Classification [Industry Sector]
If transfer, Club Name, Dates, Rotary International Number
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Recent Transfer (one year or less)
Yes
No
If RI program participant or Foundation alumnus/a, list program(s) and dates(s)
Community Activities that enhance consideration
Member proposed by (Who invited you?)
Preview PDF
Submit
Should be Empty: