GROUP 63 ROTARY CLUB OF JOPLIN | ROTARIAN OF

Rotary Club of Joplin | ROTARIAN OF THE DAY

Meeting date: _____/_____/_______

Name of R.O.D: ____________________________________

Employer: ___________________________________________

Title: ___________________________________________

Assisted in the meeting by the following Rotarians YOU HAVE SELECTED:

Invocation: _________________________

Introduction of Guests: _________________________

Song Leader: _________________________________

Years in Rotary: ______

Previous Rotary clubs: ___________

Sponsor Name: __________________

Positions Held within the Club: _______________________________)

Please indicate if Paul Harris Fellow: ___________YES ___________NOT YET

Personal Data:

City born in: _______________________

Education/College: _______________________________________

Spouse: _____________

Children/ages: ________________________________________________________________________

General Career Path: ______________________

Church: _____________________________

Other Civic Involvement: ___________________________________________________________________

What is the biggest goal you wish to accomplish this year, personally or professionally?

List something we may be surprised to know about you:

Please email completed form 2 WEEKS prior to your scheduled date to: Erin Taylor @ [email protected]