ROTARY CLUB OF PHILADELPHIA
CONFIDENTIAL APPLICATION FOR MEMBERSHIP
7/31/2017
If you would like to be considered for membership in our Rotary Club, please submit this completed
application and a current resume or CV to [email protected] and a $100 refundable
processing fee and one of our members will contact you. If you would like to receive more information about
our club, complete only the contact information section of this application and submit it to the address shown
above.
DATE OF APPLICATION:
APPLICANT NAME:
CAREER & PROFESSIONAL INFORMATION:
COMPANY NAME:
ADDRESS:
PHONE:
WORK:
E-MAIL ADDRESS:
PRINCIPAL TYPE OF BUSINESS:
POSITION/TITLE:
CURRENT AND RECENT POSITIONS
AND LENGTH:
BUSINESS/PROFESSIONAL
ORGANIZATIONS INCLUDING
LEADERSHIP ROLE:
PERSONAL INFORMATION:
HOME ADDRESS:
HOME PHONE #:
HIGH SCHOOL ATTENDED:
CELL:
COLLEGE ATTENDED:
GRADUATE SCHOOL:
(and degree, if applicable)
BIRTH DATE:
BIRTH PLACE:
LENGTH OF TIME IN
PHILADELPHIA AREA:
SPORTS OR HOBBIES:
SPOUSE’S NAME:
CHILDREN:
CIVIC, MILITARY AND COMMUNITY INTERESTS:
Please list any civic organizations you are currently active in, any military service or current veterans’
activities, or any other community involvement:
ROTARY HISTORY:
HAVE YOU BEEN A ROTARIAN?
YES
NO
If YES, please list your last club. ___________________________________________________________
Are you transferring your membership? YES____________
Have you served as CLUB PRESIDENT: YES __________ YEAR: ____________
ROTARIANS YOU KNOW: ______________________________________________________________
REASON FOR WANTING TO JOIN ROTARY:
_______________________________________________________________________________________
DUES: MEMBERS CAN CHOOSE EITHER A FULL OR A LA CARTE MEMBERSHIP DUES
PLAN. DUES ARE BILLED SEMI-ANNUALLY.
ANNUAL FULL MEMBERSHIP
$
1020
Select Plan
All Thursday Lunches at the Union League
Fellowship Meetings
Service Opportunities
Rotary Club Newsletter
The Rotarian Magazine
Exclusive Rotary Social and Networking Events
ANNUAL A LA CARTE MEMBERSHIP
$
540
Select Plan
"Pay as you go" lunches at the Union League
Rotary Club Newsletter
Fellowship Meetings
The Rotarian Magazine
Service Opportunities
Exclusive Rotary Social and Networking Events
HAPPY HOUR CLUB
$
300
Select Plan
_______________________________________________________________________________________
 A credit card is required to be maintained on file to ensure timely payment of dues.
 An application fee of $100 must accompany this application. This fee will be
deducted from your annual dues upon your induction as a member. It is refundable
if you are not inducted.
 I fully understand the privileges and responsibilities of membership in The Rotary
Club of Philadelphia.
 I agree to give one month’s written notice if I decide to terminate my membership.
__________________________________________________________________________
APPLICANT’S SIGNATURE: ____________________________________________________________
APPLICATION REQUIREMENTS:
1. Attend at least two club meetings before submitting the Membership Application.
2. Submit a completed application with a $100 application fee paid online or via check
payable to The Rotary Club of Philadelphia. This fee will be deducted from your
annual dues once you are inducted.
3. Meet with the Membership Committee to discuss membership requirements including
financial, attendance, and involvement.
4. If approved by the Membership Committee, the Applicant meets with the Admissions
Committee to share their interest in joining Rotary.
5. If approved by the Admissions Committee, the Applicant is referred to the Board of
Directors for final approval.
6. If approved by the Board of Directors, the Applicant will be notified by the Admissions
Committee.
7. Members can pay dues online or by recurring monthly payments or by check. Please
notify the Club at [email protected] if you would like to pay by check, and
an invoice will be mailed to you. Paying via check includes a $25 administrative charge
that will be added to the cost of your membership.
8. Once payment for dues is received by the club, the Applicant will be scheduled for an
Induction Ceremony at a club meeting.
9. Dues are not refundable.
MEMBERSHIP COMMITTEE REVIEW:
PROPOSER: ___________________________________________________________________________
SECONDER: ___________________________________________________________________________
PROPOSER’S SIGNATURE: _____________________________________________________________
Date Interviewed:
Approved:
Rejected:
Comments:
ADMISSIONS COMMITTEE REVIEW:
Date Interviewed:
Approved:
Comments:
BOARD OF DIRECTORS’ REVIEW:
Rejected:
Board Approval Date :
Other Action (if required):
Club President’s Signature: _______________________________________________________________
CLASSIFICATIONS COMMITTEE REVIEW:
Suggested Classification:
Committee Chair’s Initials:
Review Date:
Candidate’s Committee Selections:
Committee Chair’s Signature: _____________________________________________________________
Committee Chair’s Signature: _____________________________________________________________