Club Programs

This form should be used to suggest a program, propose a date for the program, provide a program outline and identify the person who will be hosting the program.

Program Title*
Program Description*
Name of Presenter*
First Last
Presenters Background & Experienced*
Proposed Program Date*
MM slash DD slash YYYY
Alternate Program Date
MM slash DD slash YYYY
Rotarian Host*
First Last
Is Presenter a Rotarian
- Yes
- No
Name of Presenter's Rotary Club
Visual Aid Requirements
Does Presenter Need a Projector*
Does Presenter Need the use of Laptop Computer?*
Phone
This field is for validation purposes and should be left unchanged.

Club Programs

Visual Aid Requirements