| Full Name:
First, last, and middle |
required |
| Family Name |
required |
| Call name:
(nickname) i.e. "Bill" "Jane" |
required |
| Email: |
required |
| Confirm Email: |
required |
| Joined RGHF
(year): |
required |
| Highest Rotary
Office: |
and year of service or enter N/A
required |
|
RENEWAL FEE
One option must be selected
from this list * |
Please choose one
option below:
|
|
$ 30.00 USD |
1 YR NEW MEMBER FEE |
|
|
$120.00 USD |
5 YR NEW MEMBER FEE |
|
|
DISCLAIMER Please note that Fellowship
membership dues are paid on an annual basis and
due on July 1 of each year. Individuals who
become members after July 1 are required to pay
the full annual fee as dues are not pro-rated
based on the time of year an individual becomes
a member. All payments are immediately applied
to the work of the Fellowship. No refunds or
pro-ration of dues will be made once payment is
submitted or upon cancellation of membership.
Check here that you agree with our disclaimer
* required |
|
ENTER INFORMATION BELOW ONLY IF IT IS NEW SINCE YOU
LAST REGISTERED.
|
| Rotary
Classification: |
|
|
Name of Rotary Club:
|
(Rotary-Rotaract,
etc.) |
|
Rotary District #: |
|
|
Zone #: |
|
Complete Mailing
Address:
Enter only if it has changed... |
|
| Home Phone: |
|
| Work Phone: |
|
| Cell Phone:
|
|
|
Spouse / Partner Name |
|
|
If your Spouse / Partner is a
Rotarian, please list their club |
|
|
Club Web Site URL
|
|
|
District Web Site URL
|
|
|
Recent Rotary Awards: |
|
| Recent Rotary
Activities: |
|