JULY 23, 2005 

Cavite Economic Zone Sports Complex

Rosario, Cavite

 

REGISTRATION FORM

 

ROTARACT CLUB OF : ________________________________________

 

                school based     community based

 

 

PRESIDENT :

1.

 

VICE-PRESIDENT :

2.

 

SECRETARY:

3.

 

TREASURER :

4.

 

COMMUNITY SERVICE DIRECTOR :

5.

 

CLUB SERVICE DIRECTOR :

6.

 

INTERNATIONAL SERVICE DIRECTOR :

7.

 

PROFESSIONAL DEVELOPMENT DIRECTOR :

8.

 

ROTARACT CLUB ADVISER :

9.

 

 

___________________________________________

SPONSORING ROTARY CLUB

 

 

PRESIDENT :

10.

 

NEW GENERATION/YOUTH SERVICE DIRECTOR :

11.

 

ROTARACT COMMITTEE CHAIRMAN:

12.

 

 

 

 

 

 

 

 

 

TOTAL NUMBER OF PARTICIPANTS :

 

X  P 300.00 =

 

 

 

 

 

                                     (Amount Due)

           

Please make checks payable to Rotaract District 3810 Committee.

 

Receipt No. ____________        Received by: ____________________

 

WAIVER

 

This is to certify that Rotary Club of _________________________________________ will pay the District Rotaract Assembly 2005 registration fee with the amount of ________________ on or before July 19, 2005, the last day of registration.

 

___________________________________

Sponsoring Rotary Club President

 

   Hosted by:

ROTARY CLUB of  CAVITE EXPORT PROCESSING ZONE

District 3810

 

Co-hosted by:

ROTARY CLUB OF MANILA BAY

 

SPONSORS