Contact Information First Name Please enter your first name. Last Name Your last name may only contain letters, spaces, hyphens, and apostrophes. Email Address Please enter a valid email address. This email is already in the system. Please contact customer support to make changes to your membership. Primary Phone Number Please enter a valid phone number. Gender Select One Male Female Unknown Do you have a current Rotary affiliation? I am a … ? Select Rotarian Rotaractor Non-Rotarian Please select your current Rotary affiliation. If you are not a currrent Rotarian or Rotaractor, please select "Non-Rotarian." Where is your club located? State/Province Club Name Address Information Street Address Address Line 2 City State/Province Postal Code WASH Questions What is your WASH Experience? None Some Extensive I am willing to volunteer. Comments? Comments WASH Area of Interest Select all that apply Water Sanitation Hygiene I am interested in becoming a WASH-RAG Ambassador. I am currently a member of the Rotary Cadre. Membership Levels Rotary 1-Year Membership ($25.00 USD) 5-Year Membership ($100.00 USD) Rotaract 1-Year Membership ($25.00 USD) Login Information Choose your own login name and password Username Password Confirm Password Privacy and Disclosure This site and our membership management system vendor, Member Minder Pro, LLC (dba iMembersDB), is collecting your personal information in order to process your online membership registration. Our organizations do not sell your personal information. The Registrant authorizes the collection and use personal information about the Registrant for the purpose of receiving communications and the purposes described in the policies relating to data privacy as stated in the privacy policy linked to in the site footer below. Permission may be withdrawn at any time by contacting the site's privacy officer at any time at the contact information listed in the posted privacy policy. Please check the "I Consent" checkbox below to allow us to collect, use, and disclose your personal information as described above. I Consent Submit Registration Problem! There was a system error creating your new membership. Please contact support to resolve this issue. Redirecting to payment processor...