Baltimore Rotary

Membership Application ROTARY CLUB OF BALTIMORE CITY P.O. Box 13242 Baltimore, MD 21203
First Name and Middle Initial:	Last Name:
Nickname: Home Street: Home Street (opt.): Home City: Home State and Zipcode: Home Phone: E-mail Address:	Company Name: Business Street: Business Street (opt.): Business City: Business State and Zipcode: Business Phone: Business Fax:

Past Rotary Service:

Club Name: From: To:

Offices Held:

Is Applicant a Paul Harris Fellow of Rotary International?
Yes No

Type of Membership Sought (choose one):
Active Additional Active

Classification Sought:

Other Members who know Candidate:

Personal Information

Date: Married:
Spouse's Name:

Describe Nature of Current Business
and Your Particular Function:

Previous Employment:

Military Service:

Hobbies/Special Interests:

Other Organization Memberships:

As a member of Rotary, I will subscribe to the code of ethics and principles of the organization and will make every effort to maintain at least a 60% minimum attendance at the weekly meetings. Also, I understand that the classification under which I am a member is loaned to me personally and not to my company.

I understand the quarterly dues are due within 30 days of billing. If my dues are not paid within 60 days, my membership in the Club will be suspended. After 90 days, my membership will be terminated unless I resign before that date. I also agree to pay all arrearages on or before the time of my resignation. My resignation must be mailed postage prepaid, return receipt requested, to the following address: P.O. Box 13242, Baltimore, Maryland 21203.

In the event the Rotary Club of Baltimore City initiates legal proceedings to collect my past due charges and assessments, I agree to pay all court costs and fees, interest at the rate of 18% per annum, and an attorney fee of 33-1/3% on any past uncollected dues. I agree to venue for any actions in Baltimore City District Court.

By checking this box, I, , agree to be bound by all the Rules, Regulations and Bylaws of the Rotary Club of Baltimore City, including payment of all dues, fees, assessments, including meals.