Copy the below questions to a word doc or to an email doc, complete the details and email it to rotary.infinity@gmail.com early. The information is for club records.
Title (Mr., Mrs., Ms., Dr., Rev., etc.): ________________________________
Surname/ Family Name: __________________________________________
First Name:____________________________________________________
Other Names: __________________________________________________
Call Name (Name you would like to be called by): ______________________
Place of Work (Name of Company): _________________________________
What is the main business activity of the Co.: ___________________________
Position/ Title held in the Co.:_________________________________________
Phone No.s: Mobile _________ Business __________ Residence ___________
Fax No: ____________ Email address: ________________________________
Preferred Postal mailing address (Business/ Residence/ Other): ________________
___________________________________________________________________
Have you been an Interactor, Rotaractor or Rotarian? Give details: ______________
___________________________________________________________________
Your Date of Birth: ________________________________ Age: ______________
Would you like to serve as a Board or Committee Member (Yes/ No): ___________
* I am aware & agree to pay the Joining Fee: US $20/- & Semi-Annual Dues: US $100/-
(The Semi-Annual Dues would be US $60/- for the Second Family member/ Spouse).
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