2. They Should Conduct Themselves According to the 4-Way Test

Rotary Club of Downey
Application for Membership
Prospective Member Information Sheet
Directions: The Rotarian sponsor should fill out the first and second page with the prospective Rotarian’s information. The third and fourth pages should be filled out by the proposed Rotarian. This information will be used in the Downey Rotary database. Please PRINT the information carefully.
Name: / DOB: mm/dd
Home Address:
City: / Zip:
Business Profession:
Proposed Classification: / Nickname:
Business Address:
City: / Zip: / Email:
Business Phone: / Home Phone: / Cell Phone:
Business Fax: / Home Fax: / Partner’s Name:
Summary of Personal, Professional & Community Activity:

It is the responsibility of the Rotarian Sponsor to ensure that the proposed member is aware of the following:

1.  They may not be a member of any other service club during their membership in a Rotary Club.

2.  They should conduct themselves according to the 4-way test:

§  Is it the Truth?

§  Is it Fair to all concerned?

§  Will it build Good Will and Better Friendships?

§  Will it be Beneficial to all concerned?

3.  They should be aware that the object of Rotary is to encourage and foster the ideal of Service Above Self as a worthy enterprise and, in particular, to encourage and foster:

§  The development of acquaintance as an opportunity for service;

§  High ethical standards in business and professions;

§  The recognition of the worthiness of all occupations;

§  The dignifying of each Rotarian in their occupation as an opportunity to serve society;

§  The application of the ideal of service by every Rotarian to their personal business and community life;

§  The advancement of International understanding, good will, and peace through a world fellowship of business and professional men and women in the ideal of service.

I have accepted the responsibility for introducing the proposed member to the concept of “Service Above Self” and the financial obligations of Rotary.

I, the sponsoring Rotarian, understand that membership into Rotary is by initiation only. Submission of this information does not constitute an invitation for membership. Membership can be extended only by the Board of Directors with confirmation by the general membership. With this understanding, I am requesting consideration of this proposed member.

Signature of Rotarian / Date
Personal Facts For Rotarian Club Database
Directions: Please print carefully. This information will be available to the Secretary and Officers of the Club. The year of birth is not published in the Rotary Roster.
Member: / Title: / First Name: / MI:
Last Name: / DOB: m/d/by / Degrees Held: / Hometown:
Please Check the below to indicate which is your preferred mailing address
Residential Address: / Address:
City: / State: / Zip:
Business: / Address:
City: / State: / Zip:
Company Name:
Occupation/Job Title:
URL/Web Site: / Http://
Post Office Box: / Number: / City: / Zip:
Family:
Rotary Partner: / First Name: / MI: / Last Name:
DOB: mm/dd/yy / Married: Y/N / Anniversary Date: / Remarks:
YesNo
Children’s Names:
Use space on next page if necessary / Name: / DOB: / Gender:
FemaleMale
Name: / DOB: / Gender:
FemaleMale
Name: / DOB: / Gender:
FemaleMale
Name: / DOB: / Gender:
FemaleMale
Previous Rotary Clubs
Name of Club (above) / City/State / Date Joined / Date Resigned
Name of Club (above) / City/State / Date Joined / Date Resigned
Achievements in Previous Clubs:
Previous Community Positions, Projects and Organizations:
Other Information:
I understand that my name will be published in the Club’s Hub Bub Newsletter prior to my
Induction into the Downey Rotary Club.
Signature of Proposed Rotarian: / Date:
Secretary’s Use Only
RI Number: / Paul Harris Number:
Classification Assigned: / Induction Date:
Comments:

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