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Title:
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First Name:
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Middle Initial:
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Family Name:
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Gender:
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Preferred Language:
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Former/Current Rotarian:
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If Yes, RI Membership ID number:
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Retired From Work:
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Former/Current Firm:
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Department:
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Position:
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Phone BH:
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Phone AH:
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Mobile:
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Email:
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Addresses
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Please complete your home address, the work and mail addresses are optional.
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Home
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Address:
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Suburb:
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State:
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Postcode:
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Country:
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Work
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Address:
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Suburb:
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State:
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Postcode:
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Country:
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Mail
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Address:
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Suburb:
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State:
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Postcode:
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Country:
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Send Postal Mail To:
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Rotary Magazine Subscription:
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It is a requirement of membership that you receive the monthly Rotary regional news magazine “Rotary Down Under”. The cost is $35 pa and this is included in your membership Fees.
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Members Site Login Details
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This members site requires a user name and password to gain entry. Enter your user name below. The user name should contain a minimum of 8 characters, alha characters, at least one number and not contain any non alpha characters ( e.g. "- _ . , @" ). Your user name is not case sensitive but password is!
Details of how the retrieve your system generated password will be sent via email. Once logged you can change your password.
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User Name:
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