Welshpool Rotaract Interest Form

Register your interest in joining us
Name*

First NameMiddle NameLast Name
Birth Date*

DayMonthYear
Gender*
Address*

Street Address

Street Address Line 2

Town/CityCounty

Post CodeCountry
E-mail*
example@example.com
Contact number*
Collection and Use of Personal Data. Data is saved on a secure and passworded pc. Note: Once membership is mutually agreed and this information has been entered on to the Rotary Data Management System, under GDPR, there is no justification for storing this form so it will be deleted.
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Register your interest in joining us