Rotary Doll Lovers Fellowship

DLF Membership Form

Items with red * are required.

Type of Membership:

	Rotary Club
	Individual Rotarian

* REGISTRATION OPTIONS:

PERSONAL INFORMATION:

* Last or family name:

* First name (preferred):

Status in Rotary Club:

�
Anne, Annet, Interactor or Rotaractor

* Address (full and complete, including all postal codes, etc.)Line 1:

Line 2:

Line 3:

Line 4:

�

Business Telephone:

* Residence Telephone:

(including all prefixes e.g. xxx-xxx-xxx-xxxx) with country code

Fax:

* e-mail:

GENERAL INFORMATION:

* Rotary Club:

* District:

* Years In Rotary:

Key Positions Held (President/Governor):

Nearest City or Large Town:

Attractions of Your Area:

Languages you speak:

Special Rotary Interests:

Other Interests:

Send your doll / toys by Regular Mail parcel to the Vice-Chairman