Please enable JavaScript in your browser to complete this form.First Name *Last Name *Email *Contact Number *Rotary District *Please select your districtDistrict 9800OtherRotary Club - District 9800 *Please select your clubAlbert ParkAltonaAltona CityBacchus MarshBalwynBendigoBendigo SANDHURSTBendigo SouthBrightonBrighton NorthBrunswick TullamarineCamberwellCanterburyCarltonCaroline SpringsCastlemaineCaulfieldCentral MelbourneChadstone/East MalvernCollingwoodDaylesfordEaglehawkEchuca-MoamaE-Club of MelbourneEssendonEssendon NorthEynesburyFitzroyFlemington KensingtonFootscrayGisborneGlen EiraGlenferrieHawthorn RotaryHoppers CrossingKangaroo FlatKeilorKeilor EastKewKynetonLaverton Point CookMacedon RangesMalvernMelbourneMelbourne PassportMeltonMelton ValleyNorth BalwynNorth MelbournePoint GellibrandPort PhillipPrahranRichmondRochesterSouthbankToorakWerribeeWest FootscrayWilliamstownWoodendWyndhamWyndham HarbourYarravilleRotary Club *Rotary ID number *WWC card number *Submit
