Join – Polio Survivors & Associates

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Join Polio Survivors Rotary Action Group

Name
Username*
First Name
Last Name
Nickname
Contact Info
E-mail*
About Yourself
To better report on our membership to Rotary International, we need to know some things about your affiliation with Rotary
Where do you live (country)?*
Are you a polio survivor?*
- Yes
- No
Are you an Rotarian?*
- Yes
- No
Rotary Club
Are you or have you ever been a member of any of these Rotary programs?
- Rotaract
- Interact
- Peace Fellow
- TRF Grant Scholar
- VTT
- Group Study Exchange
- TRF Cadre
Rotary District*
Have you participated in an NID/SID
- No
- No-but would like to
- Yes-India
- Yes-Nigeria
- Yes-Other Country
Become a true supporting member
Starting in 2020, we are asking members to help support our group with an annual membership fee.
Annual Membership – $25 / 1 Year
Friends Only Plan – Free
Our Friends Only plan allows you to still be counted as a Rotarian Polio Survivor or supporter and receive our newsletter, but you will not be able to view other members or other advanced features.
You will be able to complete the payment after you have confirmed your e-mail address.