New Member Application Form | Rotary Club of Westlake-Bay Village

New Member Information

Thank you for showing interest in joining our club. We look forward to learning more about you and your interests.

First Name

Last Name

Cell Phone

Home Address

Address

Address Line 2

Address Line 3

City

Country

State/Province

Zip/Postal Code

Business Name & Address

Business Name

Address

Additional Address Info

City

Country

State/Province

Zip/Postal Code

Business/Company Title

How did you hear about us? Please select all that apply or tell us more in the Other area.

Previous Rotary Member

Social Media (Facebook, Instagram, LinkedIn)

Word of Mouth/Friends & Family

Print Media (Magazines, Brochures, etc.)

Other: Please tell us more about how you heard about RI and our club.

Previous Rotary Member?

Previous Rotary Club (if applicable)

Is there anything else you would like us to know?

Date of Birth

I hereby certify that if accepted into the Westlake-Bay Village Rotary Club, that I as a rotarian, will exemplify the Object of Rotary in all my caily contacts and will abide by the Constitutional Documents of Rotary International and the Club. I agree to pay an admission fee and dues in accordance with the by-laws of the club.

Board Approval Date - For Club Use Only

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