Membership Application

Membership Application

Conveniently submit your Rotary Club application online with the following form.
You may also print this application and send it to: Vita Schmidt – c/o AAA Travel – 17220 Royalton Road – Strongsville, Ohio 44136-4400


    Home Address

    Home Phone





    Business Address

    Business Phone

    Title of Your Position

    Type of Business

    Email (home or business)







    Educational Background

    Who is your Parma Rotarian sponsor?

    Are you a former Rotarian?

    Yes No

    If yes, what club

    Length of membership







    How long have you lived/worked in the community?



    Month & day of birth (no year)



    Month & day of anniversary



    Spouse’s first name



    Children’s names & ages

    Memership in other clubs, business and professional organizations:

    What are your hobbies?

    If you had a preference on your first committee in the club, what would it be?

    Membership Development    Special Projects
    Reverse Raffle    Community Service
    Fundraising    Club Bulletn & Advertising

    What do you see as the most important need(s) to this community now?