Maple Grove Rotary Club
PO Box 1831, Maple Grove, MN 55311
New Member Application
Please complete this application and return to the Club’s Membership Chair for Board consideration.
Current Membership Chair – Tim Deets
763-710-0351
PERSONAL INFORMATION:
Full Name: / Home Phone:Email: / Cell Phone:
Home Address: / Date of Birth (MM/DD):
Spouse/Partner Name: / Anniversary:
Children (Name/age):
Any Additional Information:
BUSINESS INFORMATION:
Name: / Phone:Address: / Email:
Website URL:
Education and Professional Training:
Occupation/Specialty:
Any Additional Information:
Maple Grove Rotary Club
New Member Application, Continued
ADDITIONAL INFORMATION:
Why do you wish to Join Maple Grove Rotary?Describe previous Rotary club memberships or experience. If known, please include your previous Rotary membership number.
Tell us about yourself. What are your hobbies, interests, activities?
Rotary Communication
(please preference) / Personal (cell or home) / Business
Phone: / O / O
Email: / O / O
Mail: / O / O
ROTARY INFORMATION: (To be completed by the Rotary Club Membership Chair)
Proposed Member Classification:Rotary Sponsor:
Date approved for Membership:
Rotary Mentor:
Applicant
Signature: ______Date:______
Maple Grove Rotary Club
Talents / Skills / Interests
Each of us has many talents and skills. We also have areas of interest about which we would like to learn.
as many boxes below that apply to your current skills or your future interest:
- Accounting / Finance
- Advertising / Public Relations
- Analytical by nature
- Attention to Detail
- Audio / Video Equipment
- Auto / Bus Mechanics
- “Big Picture” Person
- Comfortable Leading
- Comfortable sticking to budgets & schedules
- Computer / Web Site Mgt.
- Doer – known for getting things done
- Enjoy doing research
- Enjoy international travel & cultures
- Excellent Planner
- Gregarious by nature
- Highly Organized
- History / Historian
- Love working with kids
- Mathematical skills
- My “yes” means yes
- Numbers Oriented
- Prefer to follow
- Prefer Leadership Role
- Prefer working in groups
- Prefer working alone
- Project Planning Role
- Process / Methods Improvement
- Public Speaking
- Publishing / Printing
- Research & Develop best practices
- Spontaneous by nature
- Strong Selling Skills
Maple Grove Rotary Club
Commitments
Please indicate how much time you expect to volunteer as a Rotarian:
- 20 — 60 min per month
- 60 — 90 min per month
- 1 ½— 2 hours per month
- 2—3 hours per month
- 3—4 hours per month
Please indicate which of the following you will commit to as a Rotarian:
- Abide by the Four Way Test
Of the things we think say or do:
Is it the truth?
Is it fair to all concerned?
Will it build goodwill and better friendships?
Will it be beneficial to all concerned?
- Attend a “fireside chat” to learn more about the Rotary club of Maple Grove
- Find a way to contribute by visiting a few Club committee meetings
- Participate in a several club service projects
- Invite one prospective member to a Rotary meeting
- Collect & turn-in at least three Gala auction items
- Attend the Rotary Gala
- Bring at least three other people to the Gala
- Participate in the “Every Rotarian Every Year” program
Maple Grove Rotary Club
New Member – Rotary International Foundation Commitment
I, ______, understand that there will be a commitment of $100 minimum donation requirement to the Rotary International Foundation within the first three (3) months of membership with the Maple Grove Rotary Club. This donation will be matched by Rotary District funds and will go towards becoming a Paul Harris Fellow. The purposes of this required donation are to introduce new members to the Rotary Foundation and to fully maximize the amount of contributions as our Rotary District only matches funds for first time donors. Please help our club reach its goal of every member receiving a Paul Harris Award.
Signature: ______Date:______