PRIOR ROTARY CLUB STATEMENT
This form is used to electronically submit a statement from the Rotary club of which the candidate was a member prior to expressing interest in seeking membership of Rotary Club of Melbourne Inc.
The President or Secretary of the candidate's prior Rotary club is requested to complete an appropriate confirmation of the candidate's membership of Rotary together with any supporting comments, as appropriate, in the space below.
I am the:
Name of Rotary Club:
Member's First & Last Name:
Date Member Joined Your Club:
Date Member Resigned/Will Resign From Your Club:
Statement Re Prior Rotary Club Membership:
Please include positions held, awards made, etc
(Be aware that the box to the right has a limited capacity of no more than 2000 characters (approx. half an A4 page). If your statement is likely to be larger than that, please prepare it in a Word format document and attach same in the next field)
Attach large sponsor statement, or additional information, in a Word format document here:
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