Membership Application Form – Lynnwood Rotary Club

New Member Application

First Name *

Last Name *

Email *

Middle Name

Nickname

Phone *

Address

Address Line 1

City

State

Zip Code

Date of Birth *

Marital Status

Gender *

Spouse's Name

Occupation

Business Name

Business Phone

Business Address

Address Line 1

Address Line 2

City

State

Zip Code

Who is your Sponsor? Do you need a Sponsor? *

How did you hear about Rotary / Lynnwood Rotary? *

Reasons for joining Lynnwood Rotary Club? *

What skills and experiences do you bring to the Club? *

What other community service experience do you have? Other nonprofit involvement? *

"No Experience" is an okay answer!

Being a Rotarian takes commitment to the Club. Are you able to make a commitment? *

What are your expectations by becoming a member of Lynnwood Rotary? *

Hobbies & Interests: *

Any additional comments or questions?