Rotary Club of Kowloon Golden Mile
Request Membership Information Form
(Please complete all boxes !)

To start, click your cursor in the "Surname" box, type your surname, then use your
"TAB" button to jump to the other boxes and fill in all the other information!


Are you a non-Rotarian (or former Rotarian) interested in obtaining
information about joining our club ?

Please give us some basic information about yourself and we will
contact you shortly to invite you to one of our club meetings:


Surname:     Other names:

Gender:     Civil Status:

Birth Date:    Birth Month:

Company:

Position:

Office Address:


Office Telephone:       Office Fax:

Home Telephone:       Home Fax:

Cellular:       Pager:  Call:

Email:  @

In the space below, please feel free to make any additional comments:



   

Please click on the "Send" button once only. 
If you make a mistake, click on the "Clear" button and start again.


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