Membership Form

required fields *

Club Information
Rotary Club:	*
Number of Members:	*
Amount of Cheque:	*
Club Contact
Name:	*
Phone:
Email:	*
Fax:
Address:
Street:
City:
Postal code:
Alternate Club Contact
Name:	*
Phone:
Email:	*
Fax:
Address:
Street:
City:
Postal code:
List Countires of Interest

Club Responsibilities
Assign a club contact and alternate contact. These people will be key contacts for exchange of information between your club and the Rotary Worls Help Network. Develope a pool of volunteers willing to help with pickups and shipments. Look for opportunities to make contact with Rotary Clubs in other parts of the world to arrange future shipments.

If you prefer - please download the pdf membership form and mail with cheque to the address below.

Membership fees are $10 per year per Rotary Club Member.
(e.g. 40 members = $400 annual dues)

Please make cheque paybale to Rotary World Help Network.

Submit on-line form application and mail cheque to:
Rotary Help Network, #315-475 Hoew Street, Vancouver, BC, V6C 2B3

We will process your application and contact you when your cheque has been received.