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* = Required Field

Rotarian (US$175)

First Name:

Last Name:

Call Name:

* District:

Rotary Club:

Attending as:

DG Year:

* Address:

* City:

* State:

* Zipcode:

* Country:

* Home Phone:

Fax:

* Email:

 Meal Package

The $190 Meal Package includes Thursday dinner, Friday breakfast and lunch, Saturday lunch and dinner, and Sunday breakfast (6 meals). There is no breakfast on Saturday, and Friday evening is left open for the class reunion dinners.

Partner/Spouse (US$175)

Leave blank if not registering a Partner/Spouse.

First Name:

Last Name:

Call Name:

Rotarian

Club (if Rotarian)

 Meal Package

The $190 Meal Package includes Thursday dinner, Friday breakfast and lunch, Saturday lunch and dinner, and Sunday breakfast (6 meals). There is no breakfast on Saturday, and Friday evening is left open for the class reunion dinners.

Confirmation and Payment

When submitting this form, you will see a confirmation screen with the calculation of the Conference fee, and you will be able to pay online. Payment may also be sent by mail. Registration will not be complete until you select a payment option.

Rotary International | Rotary Zone 23/24