Rotary District 5130
-
Home
About District 5130
Acronyms
Archives
Ambassadorial Scholar
Attendance Reports
Calendar
Club Website URLs
Community Service
Contact Us
Directory
District Assembly
District Assembly North
District Conference
District Simplified Grant
Festival of Brotherhood
Facebook Pages
Foundation Dinners
Four Way Test
Group Study Exchange
Website How To . . .
In Memorium
Institute for Leadership
Interact
International Convention
International Service
LARC
Links
Meeting Locations
Membership
Newsletters
NVRA Meetings
Object of Rotary
Online Makeup
Peace Fellows
Program Corner
Rotaract - SSC
Rotaract - SSU
Rotary Means Business
Rotary Summer Camp
RRR Meetings
RYLA
SCARC Meetings
Service Opportunities
Site Statistics
Todd Cary's Photos
Visit Schedule
Yellow Pages
Youth Exchange
Youth Protection
2011 2012 Leadership
DG Jim and Kathy Flamson take a break from the Rotary Convention and visit "Margaritaville"
Photo courtesy of Linda Sinkay
District 5130 Centennial District Assembly Registration
!
Return to
Assembly Home Page
Registration Information
<All Fields are REQUIRED - Enter NONE if appropriate>
If you have already entered information, but have not submitted your final Assembly Registration, re-enter your email address (below) and click on "Retrieve Saved Entries / Review / Calculate Total Cost" to recall your saved profile
Name
Home Club
Address
City
State
Zipcode
Phone
Fax
Email
Your Non-Rotary Partner
(if Rotarian use spearate form)
Please check all that apply: (for name badge ribbons)
Club President
Club President-elect
Club Secretary
Club Treasurer
Club Director
Paul Harris Fellow
Benefactor
Major Donor
Bequest Society
Past District Governor
Past President
AG
DCC
Your Non-Rotary Partner:
Paul Harris Fellow
Benefactor
Major Donor
Bequest Society
Event/Meal Registration Fees:
Friday April 1 Dinner $42
Beef
0
1
2
Salmon
0
1
2
Veggie
0
1
2
Saturday April 2 Assembly $40
1
2
Attitude Adjustment $5
0
1
2
Retrieve Save Entries / Review / Calculate Total Cost
Register via FAX or US Mail
Erase All Entries
Home
|
Archives
|
Attendance Reports
|
Calendar
|
Contact Us
|
Clubs
|
Links
|
Newsletters