Posted by Brian Mann
Application for Membership
 
We welcome your interest in membership. 
 
We suggest you attend a few of our club meetings or functions to ensure we are right for you, (unless you are transferring from another club or have been a past Rotarian) 
Please fill in the form below and forward it to our President or Secretary. 
 
The President of our club will be in contact within two weeks of receiving your application. If you have any questions, please feel free to speak to any of our members. 
 
Full Name ________________________________________________ 
 
Current Address  ________________________________________________________
 
Suburb__________________________   Postcode ______________ 
 
Telephone B/H ________________ A/H ____________________Mobile ______________ 
 
 Email____________________________________-______  D.O.B ______/______/__________
 
Current or Previous Job Title _________________________________________________ 
 
Past/ Previous Rotary Club Memberships_____________________ Rotary No ________
 
Partner (Emergency Contact) Name _________________________________
 
Phone No ________________
Were you referred by a Rotarian? If so, the name of the member(s) ___________________ 
 
If not, how did you hear about us? _____________________________________________ 
 
Do you have a current Working With Children check? Yes _____ No ______ 
 
I acknowledge the objects and values of Rotary, the Four Way Test, and the Rules and Fees associated with the Rotary Club of Mornington and Rotary International. 
 
 
Applicant Signature _____________________________Date _____________ 
 
Thank you for taking the time to fill out this application. We will be in touch with you again very soon.