Membership - Rotary Club of Central Citrus County

Membership in the Rotary Club of Central Citrus is by invitation only.
You must have a sponsor from the Rotary Club before submitting your membership
application. If you would like to apply to become a member of our great club,
please fill out the application form below. Your application form will be reviewed
by the Rotary Club Board of Directors and if the application is approved you will
be asked to attend a Rotary information meeting with some of the members.
The applicant will learn more about Rotary, the time and financial obligations, etc.
At the end of the meeting they will be asked if they still want to join the club now.
It is important to attend two or three Rotary Club meetings/functions to be sure
about Rotary and the club before submitting your application.
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Membership Application

Fill out the form to apply for membership in the Rotary Club of Central Citrus. Field names with an * at the end must be filled in.

Full Name*
Nickname(if any)
Date of Birth*
MM slash DD slash YYYY
City/State of Birth
Home Address*
Street Address City State ZIP Code
Home Phone
Mobile Phone
Home Email
Vocation Status*
- Working - Complete Business Secton
- Retired - Complete next 2 blocks only/Skip rest of Business
Name of Firm/Organization*
Position*
Business Mailing Address
Business Mailing Address Business City Business State Business Zip Code
Business Phone
Business Fax
Business Email
Business Website
Describe type of Business
What do you hope to get out of your Rotary membership?*
What are you interested in doing in Rotary?*
To what organizations to you belong? Professional, Civic, Social, Charitable*
Are you a current/former member of a Rotary Club?*
Dates of Membership
Can you tell us about your family. life, interests, hobbies & weekend activities
Please upload a digital photo for Rotary Directory
Accepted file types: jpg, png, Max. file size: 64 MB.
Have you attended 2 or more Rotary meetings?
- Yes
- No
Please check that you accept Rotary financial obligation
- $100 quarterly (annual total $400)
- $25 qtrly contribution to Rotary Foundation (annual total $100)
- $25 qtrly optional contribution to Club Fund (annual total $100)
Sponsor Full Name*
Membership Applicant's Signature*
Use your mouse or trackpad for your signature in the box above.
Today's Date*
MM slash DD slash YYYY
Email
This field is for validation purposes and should be left unchanged.

The Rotary Club of Central Citrus must approve the applicant prior
to membership in the Rotary Club.