Important Paperwork

Posted by Michael Knight

on Jan 30, 2015

This is an important document - and on that should be familiar to all members of Wollundry Rotary.

The form is available from the club secretary.

Wollundry Wagga Wagga Rotary - Membership Proposal form 

Part A (to be completed by proposer and returned to the club secretary)

I propose:

Title:……

Full name:……………………………………………………………………………….

Mailing address:……………………… …………………………………………………

Telephone (including area codes)

Residence: ……………………………………………………..

Business: ……………………………………………………….

Mobile:……………………………………………………

Fax (including area codes)………………………………

Preferred e-mail address: q Residence q Business.

……………………………………………………………………………………………………..

 Proposed classification:…………………………………………………………………….

 If rejoining, or a former Rotarian, list most recent club information:

Previous club name:………………………………………………………………………

Membership Dates: From:………………………. To………………………… ………

 Recent Rotarian (one year or less): q Yes q No

Previous Rotary membership ID:…………………………………………………………..

If an RI program participant or Foundation alumnus/a, list program(s) and date(s):

………………………………………………………………………………………………..

Activities that would enhance consideration as a Rotarian:

…………………………………………………………………………………………………..

……………………………………… ………………..

Proposer’s Signature Date