Contact Information
Lisa Wilhelm, Assembly Registrar, wilhelminc@earthlink.net, 415-806-3948
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User Name:
Password:
Your Information
First Name:
  
Last Name:
  
Preferred First Name (Change If Different Than Legal First Name):
if you are attending as its representative, enter the company or non-profit organization name; else leave blank::
Email:
  
Registration Type:
  
Club Name (Interactors: Select your Sponsoring Rotary Club):
  
Preferred Phone:
  
First Time Attending an Assembly?:
  
Which BEST describes your Rotary 2025-2026 year CLUB or AG role? Select one::
  
Select "Yes" to showcase your project, club, or company/non-profit at the Project Fair (We will contact you soon for details.):
Call for event Volunteers! Please select a volunteer job of interest, if any::
Select "Yes" if you need a ride:
Select "Yes" if you can give a ride:
Dietary Preferences/Restrictions, if any? Leave blank if none.:
Any mobility access or special needs? Leave blank if none.:
If you are a Rotaractor/College Student, please state the name of your college or university:
If you are an Interactor/High School Student, please state the name of your High School:
If you are a Non-D5150 Rotary Member: Please state your Club Name & District#:
Other Comments or Questions?:
 
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