Membership Application for the Lowell Rotary Club
Your NameSpouse or Significant Other’s Name
Business NamePosition / Title
Business AddressBusiness Telephone / Fax
EmailCell Phone
Primary Type of BusinessYears with Business
Residential AddressResidential Telephone / Fax
The principal activity of your work if different from that of your employer or if independently engaged in a profession.
*If you are retired, please list the position or profession you held at the time of your retirement.
*The above information will become part of the Lowell Rotary Club Directory
Rotary is an organization whose membership prides itself in community activity and involvement. We actively seek busy people who will work to make our community a better place to live and work. Please feel free to list any activities you’ve been involved in that you think would enhance your selection to become a Lowell Rotary Club Member.
If you are a former Rotarian, please list the Club(s) name, city and dates of your affiliation:
Applicant Commitment to Rotary:
I hereby certify that I am personally and actively engaged in a business, profession or professional activity covered by Rotary Job Classification and that my business or residence is located in the Greater Lowell Community or was before my retirement if now retired.
I understand that it will be my responsibility, if accepted by this Club for membership, to exemplify the Tenets of Rotary International in my daily life and all my professional activities and to abide by the Constitutional and By-laws of the Lowell Rotary Club. I also understand that part of my membership dues will provide me with an annual subscription to the official Rotary Club Magazine, and, that a portion of my dues will cover the cost of my weekly meeting lunches. As a member, I agree to pay the individual annual dues as recommended by the Board of Directors and approved by the Club Membership. My annual dues and lunch fees for July 1 through June 30 are $575. There is no Initiation Fee required. I accept the rotary pledge to attend weekly meetings as often as I can and to do my best to be available to work on projects undertaken by our club. Further, I hereby give the Lowell Rotary Club permission to publish my name and my proposed classification to its members.
Applicant’s SignatureDateSponsor’s Signature Date
Below Is For Club Use Only
Record of Club Action on Proposed Membership:
___ Received by Club Secretary Date _____
___ Decision of the Board to Recommend to Club Membership for Review: Date _____
___ Approved ___ Denied (Denial at the Board level Terminates Application Process)
___ Applicant and Individual Sponsor Notified Date ______
If approved at the Board Level, the following provisions will be “checked off” to complete the membership application process:
___ Club Members are informed of this application and given 2 weeks for consideration(Date: ______)
___ Discussion on this proposed membership and vote to Approve(Date: ______)
___ Signature Card received by Club Secretary from new member acting our dues,
Annual lunch fee schedule and our Rotary Club Constitutional and By-Laws(Date: ______)
___ Membership Approval (Date: ______)
___ Job Classification into the Club ______(Date:) _____)
___ Inducted into club on (Date ______)Orientation Session Scheduled: ______
(To be completed after acceptance of membership by the board of Directors and the Club membership). This is to be attached to the back of the Membership Application form after it is signed.
Membership Signature Card
As a member of the Lowell Rotary Club, I agree to abide by the provisions of its Constitution and By-laws and to pay, in a timely manner, the dues and luncheon fees set annually by the Club membership. Further, I accept the rotary pledge to attend weekly meetings as often as I can and to do my best to be available to work on projects undertaken by our club. As a member in good standing, I pledge to follow the concept of “Service Above Self” and to accept the principles of “Rotary’s Four Way Test!”
______
New Member’s SignatureDate
When signed, this is to be returned to the Club Secretary
02/26/2017