Electronic CORPORATE Membership Expression Of Interest Form
PRIOR TO completing the information requested below, the Corporate Executive Designee is required to access and read the Electronic EOI Information document by clicking here.
On completion of the information requested below, the Corporate Executive Designee will be asked to acknowledge that the EOI Information document has been read and its content understood, and to agree to abide by the obligations contained in that document.
When all the requested information has been added to this form, please click on the "Submit" button at the bottom of the form to lodge it with the Rotary Club of Melbourne Inc.
Kindly note that IT IS STRONGLY RECOMMENDED THAT this form be completed and submitted ALL AT THE ONE TIME. If the form is closed before completion, all information added to that time will be lost and have to be reentered. Before commencing the addition of your data, please scroll down through the form to familiarise yourself with the type and amount of information required.
AFTER YOU CLICK THE "SUBMIT" BUTTON BELOW, A COPY OF YOUR RESPONSES WILL BE SENT TO THE EMAIL ADDRESS THAT YOU HAVE PROVIDED.
We hereby express interest in corporate membership of the Rotary Club of Melbourne Inc. (the Club) and authorize appropriate consideration by the Board of Directors of the Club. If approved, we authorize publication of our organization’s name and designated officers and their classification in the Club’s various communications processes for consideration by the Club's membership. We agree to abide by the requirements of membership and to pay the joining fee and annual subscription promptly.
Company/Firm Full Name:
Street Address:
City, State & Postcode:
Website Address:
CORPORATE EXECUTIVE DESIGNEE:
Full Name:
Title:
Business Phone No:
Preferred Email Address:
Partner's Full Name:
Home Street Address:
Home City, State & Postcode:
Home Phone No:
Alma Mater:
SECOND CORPORATE DESIGNEE:
THIRD CORPORATE DESIGNEE:
FOURTH CORPORATE DESIGNEE:
ACKNOWLEDGEMENT & AGREEMENT:
I acknowledge that I have read and understand the Electronic EOI Information document attached to this form:
I agree to abide by the obligations contained in the Electronic EOI Information document attached to this form:
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