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KSU Rotaract Club Membership Interest Form
By filling out this form, you are taking the first steps toward joining a profitable organization. You will soon be added to our listserv, where you will receive updates about upcoming events and meetings. Please fill out the form with as much or as little information as you desire. Thank you!

First name: White Last name:
Email address: White Phone:
Major: White Year:


Areas of Interest (select all that apply):
Community Service
International Service
Professional Development
Youth Service
Club Service

Are you interested in participating in our Mentor-A-Rotoractor program?
Yes No Maybe

Are you willing/able to pay member dues ($10)?
Yes No

How did you become aware of the Rotaract Club?

What interests you most about Rotaract and what would you like to contribute to the organization?

What kind of community service experiences have you had?





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designed and updated by Kraig Thompson