ROTARY DISTRICT 5440
2024 DISTRICT CONFERENCE
MAY 16-18, 2024
Contact Information
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Your Information
First Name:
  
Last Name:
  
Badge Name:
Email:
  
Club Name:

Preferred Phone:
Secondary Phone:
Address 1:
Address 2:
City:
Zip/Postal Code:
Country:
State/Province:
Is this your first District 5440 Conference?:
  
Are you a Paul Harris Fellow?:
  
Level of giving to TRF (example PHF+3 or Major Donor):
Group:
Your Partner/Guest Information
First Name:
Last Name:
Badge Name:
Email:
Club Name:

Preferred Phone:
Secondary Phone:
Address 1:
Address 2:
City:
Zip/Postal Code:
Country:
State/Province:
Is this your first District 5440 Conference?:
Are you a Paul Harris Fellow?:
Level of giving to TRF (example PHF+3 or Major Donor):
 
Group:
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