ExpressInterestForm

Expression of Interest in Joining the Rotary Club of Sunbury.

Please fill in the following data as far as possible. Name, Phone Number and Email are Mandatory.
If you are retired please indicate in the Business/Profession field (Engineer).
Please use ` not ' in your name and _ for hyphenated names if required .


Title:

First Name:
Last Name:
Phone Number:
Email Address:
Business/Profession:

A brief description on why you would like to join the Rotary Club of Sunbury.

If rejoining or a former Rotarian, list the most recent club information.

Title:
First Name:
Last Name:
Home Address:
Town:
Post Code:
Mobile Phone:
Email Address:
Business/Profession:
Proposed By:
Previous Club Name:
Date From:
Date To:
Previous RI Number:
Personal Comments
Date Proposed to Club:
Date Viewed By Secretary/Membership Director:
Date Sumbmitted to Board:
Date Former Club Contacted
Standing with Former Club:
Classification:
Classification Approved:
Date of when Information Session held:
Date of Admission Fees Received:
Date Admitted as a Member:
Date Entered into RI/Club Database:

Please read the following links Reasons for joining Rotary. and
Our Guiding Principles.

Pardon our security measures. Please perform the following operation


	+		=

Rotary Club of Sunbury respects privacy and is collecting this information with respect to your interest in our club only. The information will be used for administration purposes and to contact to discuss your interest in our club. The information will not be disclosed to any other party other than required by law.

For more information or queries please: Contact Us