Full name of proposed member candidate, First, Mid, Last
Professional certifications (MD, CPA, JD, PhD, etc)
Date of birth needed so Rotary can calculate profiles of club demographics. The year will not be made public.
Address of proposed member (Street, Apt, etc)
Name of business, organization, etc (where you work)
List your occupation, work title, etc
Work address of proposed member (Street, Apt, etc)
List your occupation, work title, etc while you were working
List activities, professional affiliations that would enhance consideration as a Rotarian.
Name of current Rotarian proposing member candidate