Add New Member

Add New Member		Use this form to report to District 5220 the addition of a new member to your club. Remember to also report this addition 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
Call Name			Optional
Gender			Optional
Spouse/Partner Name			Optional
Mailing Address (Street or PO Box)
City
State
ZIP Code
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
Date of Birth			Optional
Kind of Member
Sponsor			Optional
Comments			Optional
Check your entries before pressing Submit. To clear all entries press Reset.