Rotarian Registration Form
*Rotarian Name:
Work Phone:
Home Phone:
Fax:
*Email:
(Email is the best way to communicate with everyone involved. If you do not have your own email address, please provide us with a friend's address so that we may send you the necessary updates.)
*Name of Rotary Club:
*Number of schools you wish to attend:
(You may attend other schools during the month of April.)
I would like to help out on the following committees:
Organizing Committee:
Loot Bag Committee:
PR/Media Committee:
Sponsor Committee:
Telephoning Committee:

For more information, contact Rotarian Ron Manfield for assistance at: ronmanfield@mpcmusic.com or 416-248-4952.
* shows the required fields.

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