The Rotary Club of Cumberland/Lincoln

Twice Monthly Meetings (In-Person): Monday – 12:15pm @ Amica Mutual Insurance Co.

100 Amica Way Lincoln, RI

NEW MEMBER APPLICATION

PERSONAL INFORMATION

*Name:

*Hm. Address:

Preferred Contact Phone #:

Preferred Contact Email:

EMPLOYMENT INFORMATION

*Employer Name:

*Occupation:

Wk. Address:

How did you hear about Rotary?

We are looking for members who have a desire to be involved with service projects and fundraisers as well as future leadership positions.

Each member pays approximately $200 in Rotary Dues per year. In addition, with in-person meetings, each member also contributes to the lunches at $12 per person.

* Required field

Once you have completed this form please email it to clrotaryri@gmail.com your membership will be given further consideration.