RI Convention in Taipei, June  13-17, 2026
Come back to this form anytime to add and edit information.  
Any questions, please email DGN Rich Proctor at rotaryrich1@gmail.com 
Secure a room in the D5000 block by Oct 15 and make the $400 deposit by Oct 27, 2025
Contact Information
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Your Information
First Name:
  
Last Name:
  
Email:
  
Club Name:

Preferred Phone:
Address 1:
Address 2:
City:
Zip/Postal Code:
Country:
State/Province:
I'd like a room in the D5000 block at the Fullon Taipei East Hotel. Commitment due in Oct 15 to secure your room. Choose room size below:
What hotel are you staying at, if not in the D5000 block?:
Check-in date, Check-out date.:
Jun 14 -I signed up for Host Hospitality night:
Your Partner/Guest Information
First Name:
Last Name:
Email:
Club Name:

Preferred Phone:
Address 1:
Address 2:
City:
Zip/Postal Code:
Country:
State/Province:
I'd like a room in the D5000 block at the Fullon Taipei East Hotel. Commitment due in Oct 15 to secure your room. Choose room size below:
What hotel are you staying at, if not in the D5000 block?:
Check-in date, Check-out date.:
Jun 14 -I signed up for Host Hospitality night: