Membership Application Name:* First Middle Last Nickname:Residence Address:* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code E‐mail:* Phone:*Alternate Phone:Birthplace:Date of Birth:* Date Format: MM slash DD slash YYYY Spouse’s Name: First Last Spouse’s Nickname:Number of Children:Children’s Names:Business Name:Business Address: Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Classification (describe type of business, profession, or institution):Years in Business:Years with Firm:Current Position:Duties & Responsibilities:Schools & Degrees Received:Professional Designations:Other expertise:List your civic, trade, fraternal, social and community service organizations; explain why you are involved with each and what leadership initiatives you provided to each organization:Hobbies:Musical Instruments:Foreign Languages:How did you learn about Rotary?How did you hear about the Morrison’s Cove Rotary Club?Are you a former Rotarian?*YesNoWhen & where?*Explain specifically how you see yourself contributing to our concept of "Service Above Self."*Please check appropriate committees on which you would like to serve:MEMBERSHIP Membership Recruitment, Engagement & Retention – New member recruitment and retention along with providing activities to engage new members and promote relationship building within MCRC. Social & Networking – Plans social activities and encourages professional networking among members. PUBLIC RELATIONS Public Relations – Promotes awareness of MCRC including our events, projects, and members. SERVICE PROJECTS Autumn Glory Ride Civic Parade Golf Outing Past President Dinner Road Clean Up Day Rotary Recognition Days YOUTH Career Fair Dictionary Program “Four‐Way Test” Speech Contest Interact Club International Rotary Youth Exchange RYLA Scarlet Dragon Back Pack Program Student of the Month Current Rotary Members you know:Referred by:Date: Date Format: MM slash DD slash YYYY Name of Applicant:* First Last Signature of Applicant:*Date:* Date Format: MM slash DD slash YYYY Membership Dues* Total $0.00