Change Member Info

Change Member Information Use this form to report to District 5220 the change of member information for your club. Remember to also report this change to Rotary International through the use of the RI Member Access.
Club Name
Name of individual submitting form
Email address of individual submitting form
Member First Name
Member Middle Initial or Name		Optional
Member Last Name
Enter only only those fields below where you wish to report a changed value
Gender		Optional
Spouse/Partner Name		Optional
Mailing Address (Street or PO Box)		Optional
City		Optional
State		Optional
ZIP Code		Optional
Home Phone	Include Area Code	Optional
Work Phone	Include Area Code	Optional
Work Extension		Optional
Fax	Include Area Code	Optional
Cell Phone	Include Area Code	Optional
Member Email		Optional
Occupation		Optional
Date of Admission		Optional
Date of Birth		Optional
Kind of Member		Optional
Sponsor		Optional
Comments		Optional