MEMBERSHIP OF ROTARY
We Could Not Do It Without Them

PLEASE FILL OUT OUR ONLINE APPLICATION

Please fill out the Membership Proposal Form below and submit to our Club. A representative will get back to you soon. Thank you for your interest in Palm Desert Rotary Club!

First and Last Name:
*
Business Street Address:
Business Suite #:
Business City:
Business State:
Business Zip:
Business Telephone:
Home Street Address: *
Apartment #:
Home City: *
Home State: *
Home Zip: *
Home Telephone:
Email Address: *
I am applying for the following type of membership: *
If a former Rotarian, list club(s) and dates:
Name of firm and executive position (former firm and executive position, if retired):
Activities which would enhance consideration as a Rotarian: