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Home > Club Resources > Secretary > Club & District Leadership Form

Club & District Leadership Form
 

Please complete this form to submit the names and contact information for club and district leadership positions.  This information is used ONLY for official Rotary purposes and is not made available for any other use. Complete one form for EACH office or position. 

This form DOES NOT submit new club or district positions to Rotary International.  To learn more about sending newly elected officers' names to RI, click here.

SELECTING THE CORRECT POSITION / ROTARY YEAR: Select the Rotary Year and Position that the newly elected person will hold in the related Rotary Year.  For example: Presidents-Elect who will serve as President during the 2008-09 Rotary year should select 2008-2009 as the Rotary year and "President" as the Club Position, not "President Elect".  This indicates that this Rotarian will serve as President during the 2008-2009 Rotary year.  This holds true for all "Elect" or "Nominee" positions.

* = Required

* First Name:
Middle:
* Last Name:
* Salutation / Call me:
 (Mr., Ms, Mrs., Dr., etc.) Title:
(Jr., Sr, III, etc.) Suffix:
* Rotary Year:
* Rotary Club of:
*Club Position:

To select multiple positions, hold the "CTRL" key and click on each position that applies.
* District Position:

To select multiple positions, hold the "CTRL" key and click on each position that applies.
* District Committee Chair:

To select multiple positions, hold the "CTRL" key and click on each position that applies.
* Address:
* City
* State:
* Zip:
Home Phone:
Work Phone
Cell / Mobile:
FAX:
E-mail:
Spouse/Partner First Name:
 Spouse/Partner Last Name:
Spouse/Partner
is a Rotarian?:
Comments/Suggestions:
* Submitted by:
* Your e-mail address:
(in case we have questions about this information)

Thanks for using the District 6150 web site.
Link to this form: www.Rotary6150.org/go/dataform
Updated January 8, 2008, Reviewed January 8, 2008

 
 

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