NEW MEMBER APPLICATION

Prior to submitting an application, applicants must attend at least two Rotarian events: one Rotary Club breakfast or luncheon, one service event, or one social event. We recommend you attend one service event and one social event. In addition, applicants must obtain a letter of endorsement from a Rotarian (from any Rotary Club) or a letter of endorsement from a member of Rotaract of West Georgia. Please note that all applications are considered confidential and will only be reviewed by members of the Club's Board of Directors. Applications will be reviewed to assess an applicant's qualifications for membership based on the following criteria:

Leadership
Community Service
Demonstrated Interest in Membership
Overall Presentation
Demonstration of Rotaract's Core Values
Rotarian & Rotaract Endorsement

APPLICANT INFORMATION

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Birth Date

YYYY

Hometown City and State

Undergraduate Degree

Undergraduate Major

Undergraduate School

Graduate School Degree

Graduate School

Employer

Job Title

Industry

How did you learn about Rotaract?

T-Shirt Size

PARTICIPATION

Applicants are required to attend at least two events prior to submitting an application for membership - one breakfast or luncheon (Learn), one social event (Socialize), or one Service event (Serve). Please list ALL Rotaract events you have attended below.

Learn Events

Serve Events

Social Events

Community Service

Please list/describe any community service event(s) or organization(s), any leadership positions outside of work, and/or any program(s) you are actively apart of.

By submitting this application, I grant permission to Rotaract of West Georgia to use my image (photographs and/or video) for use in media publications, including, but not limited to, newsletters, social media, website, and annual report.

I Agree