Visitor Pre-Register

Visitor Pre-Register

Save time registering, Walk Right In!
I am a GUEST registering myselfI am the Host Member registering a guest
Member Information

First NameLast Name
Guest Information
Name of the Guest*

First NameLast Name
Company
Industry
Email*
example@example.com
Phone Number*
The Member that invited you:
Is the visitor a Rotarian?

Yes (includes Leadership Impact Group)NoSome time ago
Guest Rotarian's Home Club
Luncheon Cost Assignment
How would you prefer to handle lunch today?*

Charge to Host MemberLeadership Impact GroupPaid by Guest: Credit Card (see below)Paid by Guest: Venmo or PayPal (@charlotterotary)Paid by Guest: Cash (see Guest Desk)Charge to Membership Committee (Prospective Member)Speaker GuestNo Food

Guest Lunch

$30 Quantity

Leadership Impact Group

$20 Quantity

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country