Membership Proposal Form
Part A (to be completed by the proposer and returned to the Membership Committee Director)
I, a member in good standing, propose:
Mr., Ms,
Mrs., Dr. / Middle initial
Mailing Address:
Residential Address:
Tele. No: / Cellular No.:
Current Employer:
Position:
Address:
Telephone No:
e-mail:
Membership type: / Active / Honorary
Proposed Classification:
Complete only if transferring from another Rotary Club or a former Rotarian
Name of Club:
Address:
Position Held:
Dates:
From: / To:
I have known the Applicant for:
I have come to know the applicant through:
I confirm that the applicant has completed requirement “A” and at least “2” of “B, C, D and E” below. (Mark an X below to signify requirements met):
(A)
Attended at least 4 weekly meetings in the last 8 weeks / (B)
Attended at least one Committee Meeting / (C)
Has participated in at least one Community Project / (D)
Has participated in at least one Fund-Raising Event / (E)
Has attended at least one Fellowship Event
State why you believe the Applicant would be a good Rotarian.
Proposer’s Signature / Date

To the Board of Rotary Sunrise and the Membership of Rotary Sunrise

I hereby certify that I am qualified for active membership by my current or former status as a business professional, or community leader or as a Rotary Foundation alumnus/a, and by having a place of business or residence within the Club’s locality or surrounding area.

I understand that, if accepted for membership, it will be my duty to exemplify the Object of Rotary in all my daily contacts and activities and to abide by the constitutional documents of Rotary International and the Club and to pay annual dues in accordance with the Club’s By-Laws. I hereby give permission to the Club to publish my name and proposed classification, if applicable to the Membership.

Proposed Member Name:
Proposed Member Signature:
Date:
To be completed by Club Secretary
Classification: / Action on Proposal / Date
If Member is a former Rotarian, provide Club and District information: / Received by Secretary:
Club name: / Former Rotary Club contacted (if former Rotarian)
□ In good standing □ Not in good standing
District number: / Submitted to Membership Committee:
Club ID number: / Committee decision received:
□ Approved □ Disapproved
Dates: ______
From To / Board decision received:
□ Approved □ Disapproved
Rotary membership ID number: / Proposed to the Club:
(if any objection has been filed the Board should address the issue at the next meeting)
If an RI program participant or Foundation alumnus/a, program(s) and date(s): / Final approval by Board:
Mentor assigned to assist: / Rotary orientation meeting held:
Rotary magazine subscription:
□ The Rotarian
□ Rotary regional magazine / Committee assigned:
______
Signed form and admission fee received:
Admitted to membership:
Entered into Membership Access (Club Runner):

Rotary Sunrise - New Member App 11042010.doc