ROTARY CLUB OF THE
Membership Proposal Form
Name____________________________________________________
Business
address____________________________________________
Business
phone ____________Fax_____________e-mail_____________
Employer/Business_____________________________________________
Position
in company___________________________________________
Proposed
Classification________________________________________
A brief
description of the candidate’s position and job responsibilities:
A brief
description of activities or experiences that support the application:
Professional
or Personal References:
Name___________________________Phone____________________
Name___________________________Phone____________________
How long have you known the candidate?_____________________________
Has the candidate visited ECRC?___________________________________
As the proposer, I believe
the nominee to be:
¨
Fully
informed of the requirements of Rotary membership;
¨
Associated
with a company regarded as ethical; and
¨
Holding a
position to exercise decisive influence over his/her business or firm.
I have spoken with the candidate and advised him/her
of the review process.
Date_________________________Proposer____________________________
Proposer: Please send completed form to Thom Murray by Fax (206)
285-3469 Attn: Thom Murray
or
Candidate’s Statement:
I hereby certify that I am qualified for membership both by the
current/former executive position and by having a place of business or
residence within the club’s territorial limits, adjoining territory, or the
same city in which the club is located.
I
understand that it will be my duty, if elected, to exemplify the Object of
Rotary in all my daily contacts and activities, to actively participate in
Rotary Club activities, and to abide by the constitutional documents of Rotary
International and the club. I agree to
pay an admission fee of $150.00 and the annual dues of $1250.00 (including
meals) in accordance with the bylaws of the club. I hereby give permission to the club to
publish my name and proposed classification to its membership
Date Candidate’s
Signature
Name of
Proposed: _____________________________________
Process
Start Date:____________
Induction
Date:_____________
Record
of Action on the Proposal:
Form
received ___________________________________
Newsletter
notified_____________________________________
Classification
determined ________________________________
References
checked (Committee Member)______________________________
Submitted
to the board on (Jay)_____________________________________
Board
Decision on____________________________________________
Headshot
submitted (Committee Member) ______________________________
Notify
sponsor/speech ____________________________________
Badges
_____________________________________________
New member
notebook _________________________________
Proposed
notified on__________________________________________
Signed
form/admission fee/dues_________________________________
Induction
Date______________________________________________