Clayton Rotary Club Membership Application

Clayton Rotary Club
Please enable JavaScript in your browser to complete this form.

Please fill out this application completely to be considered for membership. NOTE: If you experience any technical difficulties with this application or have questions, please email: [email protected]. Please describe the problem you are experiencing and we will respond.

Title
Name
Suffix
Please put the name you would like to use for your Rotary Club Nametag
Under your name it says what business or vocation you are in. What do you want associated with you on your name tag? It can be general or a specific job title.
Date of Birth
Clayton Rotary Club Rotarian that is sponsoring your application. If you don't have one, please visit our club and meet our members and we'll get you a sponsor!
Only one sponsor is required, but if you have more than one sponsor list additional name(s) above.
Home Address
Business Address
Preferred Mailing Address
Are You Married?
If married, what is your Anniversary date?
Spouse/Partner Name
Is your Spouse/Partner a current Rotarian?
Date Joined
Have you ever been a member of a Rotary Club?
If you answered "Yes", list all Rotary Clubs you have been a member of and the dates you were a member. If you answered "No", enter N/A.
List any type of clubs or service organization you have been a member of with the Offices/Years and any achievements in each club. Enter N/A if you have not ever been a member of a club or service organization.
Please list what interests you have and any hobbies you enjoy.
Are you involved in community organizations (board member, volunteer, etc.) projects, outside organizations. Please tell us about your involvement including any leadership positions held.
What interested you in wanting to join our Club/Rotary?
Click or drag a file to this area to upload.
Please upload a headshot of you in .jpeg or .png format. This will be posted on our Club website on the Members' page if you are approved. Photo Requirements: Only headshots. No other people, animals, businesses, or advertising in the photo. Make sure the photo is clear-no dark or blurry images. Please make sure the background is simple.
Save and Resume Later