New Member Form

First name

Last name

Email

Phone

Address

Name of Referral (Optional)

Business/ Employer Name

Business Description

Business Address

Proposed Classification:

Previous Rotary Club

Some vocational and personal background details that will enhance your activities as a Rotarian:

I hereby certify that if accepted to Membership of the Rotary Club of Detroit, that I as a Rotarian, will exemplify the Object of Rotary in all my daily contacts and will abide by the constitutional documents of Rotary International and the club. I agree to pay an dmission fee and dues in accordance with the bylaws of the club.

I agree that the information on this application represents me truthfully.

E-Signature

Date (mm/dd/yyyy)