Nomination Form for a Transfer or Reinstatement - Rotary Club of Ann ArborRotary Club of Ann Arbor

Note to candidate: Please complete the form below to reinstate your membership in the Rotary Club of Ann Arbor or transfer/reactivate your membership from another Rotary or Rotaract Club. Your request will be evaluated by the Membership Committee with a recommendation made to the Board of Directors at its next scheduled meeting (normally the third Wednesday of the month). You will be contacted shortly thereafter.

Self-Nomination Form for a Former, Transferring, or Reinstating Rotarian

Your name:*
First Last
Your preferred mailing address:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your preferred email address:
Your preferred telephone number:
Your current company, institution, or profession (or principal one if retired):
Name of your current or most recent Rotary Club and approximate dates of membership:
Please list any friends, acquaintances, or other relationships you have with our club. If you wish, include any personal information, e.g. hobbies or other interests, that will help us connect you with potential mentors:
Please tell us why you are interested in joining (or rejoining) our club:
Please indicate any Rotary-related interests and passions you intend to bring to our club:
Please describe any experience or skills that you hope to gain from membership in our club:

If you prefer to send a nomination form by USPS or email, please contact our Administrative/Financial Manager.

Self-Nomination Form for a Former, Transferring, or Reinstating Rotarian

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