New Membership Form

Rotary Club of Red Deer Sunrise. 

New/Former member application form. 

New/Former Member Name:___________________________________ 

Sponsor Name:_____________________________________________ 

Personal Information: 

Home Address:____________________________________________________________________________________ 

Date of Birth:______________________            Telephone Number:_(____)_______-__________               

Email Address:____________________________________________ 

Preferred mailing address if different from above: ______________________________________________________ 

Optional Information: 

Spouse/Partner Name:__________________________       Marriage Date:________________________ 

                       Day               Month                 Year 

Dependants: Number of Girls___________        Number of Boys_____________ 

Employment Information: 

  Company Name:______________________________          Position/Title:______________________________ 

    Business Address:____________________________________________________________________________ 

   Business Phone Number:_(_____)________________ Business Email_________________________________ 

Personal Interests: 

What interest you about Rotary? i.e. Youth projects, International projects, Community service projects? 

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 

Rotary Club of Red Deer Sunrise. 

New/Former member application form. 

Former/Transferring Rotarian 

Rotary Membership Number:_______________Last Rotary Club Name:____________________________________ 

Rotary District #:__________________________ 

Date of membership From:_____________________to:_________________________ 

                                                Day           Month           Year                 Day               Month                 Year 

Rotary Club Positions Held 

____________________________________ 

____________________________________ 

____________________________________ 

____________________________________ 

Rotary Designations i.e. Paul Harris 

____________________________________ 

____________________________________ 

____________________________________ 

____________________________________ 

Signature:________________________    Date:___________________