How to Become a Member
 

 

 

Rancho Santa Fe Rotary
P.O. Box 2576
Rancho Santa Fe, CA 92067
 
 
Membership Proposal Form
 
Candidate:                                                                                         Date: 
 
Mail Rotary magazine to home:____ or office:____ or on line:____
 
Company Name:
 
Business Title (Rotary Classification):
 
Business Address:
 
Business Phone:
 
Home Address:
 
Home Phone:
 
Email:
 
Cell Phone:
 
Related Activities:
 
Why do you want to be a Rotarian?
 
 
College/University:
 
Birth Date:
 
Spouse’s Name:                                                         Anniversary Date:
 
Sponsor:
 
FINANCIAL RESPONSIBILITY: I hereby agree to provide Initiation dues of $ 200.00* as well as one quarter’s dues of
$325 with this application for membership.  The payments will be processed only after the final Board approval is secured.
I further agree to keep my membership account current within 30 days of being billed. For your convenience, may we charge your credit card monthly or quarterly for your dues? Yes____     No____  cc Number______________________Exp._______
 
Name:                                                                                    Date:
                                                                                 
*$100 for former Rotarians
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For office use:                                                                                    
Application Received: __________                                                              Board: ______
Ten Day Letter: _____                                                                     Induction Date: ______
Rotary International ID Number (if former Rotarian): ___________________
 
Rosters: RI ________          District ________              Club ________     Darcy ____