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The Paul Harris Society of District 5150
Membership Form |
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The Paul Harris Society
Each donor who annually contributes $1000 or more to
The Rotary Foundation’s Annual Programs Fund, PolioPlus, and PolioPlus Partners, or the Humanitarian Grants Program will be awarded membership into The Paul Harris Society. |
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v I wish to become a Member of the Paul Harris Society
v I promise to contribute $1000 annually to the Rotary Foundation.
v I wish my donation to be designated to the Rotary Foundation's Annual Programs Fund unless directed otherwise
Please review the options below and select the one you wish your Club and District to process. Type in the required information. When you have finished selecting your Option please enter your Contact information. All items must be provided. If you need to start over Click the Clear Form button to clear the form. When you are finished click on the "SUBMIT my Option & Info" button. Your selected option, data and requests will be sent immediately to the District 5150 Paul Harris Soceity chairman Russ Ketron so that all contribution records may be coordinated with TRF.
Make your checks payable to The Rotary Foundation. Note on the check :
Deposit to Annual Programs Fund, PolioPlus, PolioPlus Partners, or the Humanitarian Grants Program. |
| OPTION 1: |
Select this option, enter your contact information below and THEN click on SUBMIT my Option & Info. Then deliver your $1000 check to your Club Foundation Chair or Secretary. |
| OPTION 2: |
Select this option, enter your check amount and contact information below and THEN click on SUBMIT my Option & Info. Then deliver your check for the amount needed to total $1000 with your previous contribution made to the Annual Fund this current year to your Club Foundation Chair or Secretary. |
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Enter Amount of my check |
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| OPTION 3: |
Select this option to use the TRF-Direct contribution form. Download, print, complete and sign the form. Then deliver the form to your Club Foundation Chair or Secretary.Click here to download and print the TRF-Direct form. This form allows me to use my Credit Card or Banking Account to make automatic contributions to TRF on a monthly, quarterly or annual basis (credit card) OR periodic withdrawals on specified dates from my Banking account. |
| HELP: |
I need to confer with my Club Foundation Chair or Secretary about my TRF contributions status. Please have the Chair or Secretary contact me. |
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My Contact Information
(Very Important to provide all this information so that District can coordinate records with TRF) |
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William Koefoed
