The Rotary Foundation Cadre Of Technical Advisers

Registration Form

If you would like to be considered for service as a volunteer member of The Rotary Foundation Cadre of Technical Advisers (the cadre), please complete this form in full and forward it to your district governor for his/her review and signature. As a member of the cadre, information included on this registration form, including your contact information, may be shared with other members of the cadre and Rotary senior leaders in order to assist the cadre in fulfilling their role. You must also attach a current C.V. or resumé with this application.

Name:
Address:
Phone number(s): / Fax number(s):
E-mail: / Occupation:
Rotary Club: / Rotary District:
Current/past Rotary offices held:

Professional Credentials (specify licenses or degrees held):

Degree/License / Subject Areas / Where Received / Year

Your Skills (professional): There are seven cadre sectors. Please check the sector(s) in which you are qualified to serve as a consultant or trainer.

PEACE AND CONFLICT PREVENTION/RESOLUTION

DISEASE PREVENTION AND TREATMENT

WATER AND SANITATION

MATERNAL AND CHILD HEALTH

BASIC EDUCATION AND LITERACY

ECONOMIC AND COMMUNITY DEVELOPMENT

FINANCIAL AUDITING

Please detail all areas of your particular specialization, including professional and educational experience. Please do not include experience as a Rotary Foundation grant project contact.

International and Volunteer Experience:

Please tell us about countries in which you possess regional or cultural familiarity. Please specify length of residency in each country.

Please tell us about your volunteer activities (e.g. involvement with Rotarian Action Groups (RAGs) or participation in international projects, including those outside of Rotary.)

Language Proficiency:

Language / Level / Use the following level codes:
1 = Can understand and respond to questions about personal background and ask directions
2 = Can communicate ideas on non-technical subjects and understand 50% of what native speakers say
3 = Can carry on a conversation on most subjects
4 = Speak and respond almost as well as in native language
5 = Native language

Please sign and date this form to certify the information provided above.

Volunteer / Signature / Date

Please make sure that you have attached a current CV or résumé with the application.

Please mail, e-mail, or fax this form to TRF Cadre Specialist Christian Pepera

Phone: (847) 866-3357. Fax: (847) 556-2153

Email:

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