Personal Details
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Email Address
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Phone Number
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National ID No./Passport
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Date of Birth
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Home Estate/Street Address
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Home Town/City
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Home Country
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Afghanistan
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Wallis & Futana Is
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Education and Employment
Highest Level of Education
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PHD
Masters
Undergraduate
A-Level(High School)
O-Level(Primary School)
Name of Institution
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Qualifications
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Business Person/Employee?
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Employee
Retired
Non of the Above
Company Name
Company Specialization
Position in Company
Company Email
Company Phone Number
To what organization do you belong?
Rotary Status
What do you want to do in Rotary?
Current Rotary Membership Status
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Former Rotarian
Tranferring Rotarian
Transitioning Rotaractor
Club Name(If Former/Transferring)
Do you have a Transfer Letter from your club
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No
Not Applicable
Attended any of our meetings/Service projects
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Yes
No
How did you find out about Rotary Eclub Safari?
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Referred by Non-Rotarian
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