Rotary Club of Haliburton

                Proposal for Membership

 Personal  Information:

Name:_____________________________    Married (yes/ no) __________________

Home phone:________________________    Work phone:______________________

Email:__________________________________       Fax _______________________

Home address:_________________________________________________________

___________________________________  Postal Code_______________________

Date of Birth________________ Spouse name (if applicable)____________________

Education/ Special Awards/ Other Club Associations:___________________________________________________________

 _____________________________________________________________________

Employment Information

Employed at/ by:________________________________________________________

Job at the organization:___________________________________________________

Proposal/ Club Information

Name of Rotarian proposing this person: _____________________________________

Proposed for membership on (date) :_________________________________________

Membership Committee

Referred to Membership Committee (date):____________________________________

Approved or Rejected (date)  _______________________________________________

Classification:____________________________________________________________

Dues collected (date)_______________________________________________________

Induction into club (date)___________________________________________________

[ Home ] [ May 22 ] [ Members Only ] [ Site Map ] [ Exchange Student ] [ Back Issues of Rotooter ] [ Proposal Sheet ] [ Where Clubs Meet ] [ Past Presidents ] [ Links ] [ Our President ] [ Paul Harris ] [ Local Weather ] [ Map ] [ Credits ] [ Future Meetings and Events ] [ Committee Lists ] [ Awards ]