How to Become a Member

We encourage you to visit our club to see if it’s a good fit for you. If you decide to pursue membership, simply fill out the form below and your application will be sent to our Membership Recruitment Chair Carl Dewitt for review. Thank you for your interest in the Rotary Club of Lynchburg-Morning.

Contact Information

Name

First Name

Last Name

Mailing Address

Anytime Rotary needs to send you mail, this is the address we will use. This is also the mailing address for our monthly magazine The Rotarian.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Email

Mobile Phone

(###)

###

####

Residence Phone

(###)

###

####

Have you been a member of Rotary previously?

Yes

No

If a former Rotarian, list name of prior club(s) & duration of membership:

Employment Information

If you are not currently employed or you're retired, simply write N/A.

Position

Business Email

Business Phone

(###)

###

####

Will your employer be covering the cost of your dues?

Yes

No

Additional Information

Hobbies, involvement in other organizations, how long you've lived here, etc.

Tell us a little more about yourself

Spouse Name

Birth Date

MM

DD

YYYY