Rotary Club of: Choose Club Andover Arkansas City Augusta Beaver Boise City Cimarron Derby District 5690 Dodge City East Wichita El Dorado Garden City Greensburg Guymon Hugoton Hutchinson Johnson Kingman Kinsley Larned Liberal NewtonOld TownPratt Sublette Syracuse Texhoma Ulysses Wellington West Sedgwick County Sunrise West Wichita Wichita (Downtown) Winfield  

Rotary Year:    

Incoming President:

        Name:                  

        Spouse's Name:   

        Address Line1:   

        Address Line2:   

        City, State, Zipcode:   

        Cell Phone (including area code):   

        Home Phone (including area code):   

       Office Phone (including area code):   

       Fax (including area code):                   

       email address:                                    

Incoming Secretary:

        Name:  

        Spouse's Name:   

        Address Line1:   

        Address Line2:   

        City, State, Zipcode:   

        Cell Phone (including area code):   

        Home Phone (including area code):   

        Office Phone (including area code):   

        Fax number (including area code):      

        email address:                                    

Please submit report no later than December 31 for officers serving June 1 - July 31 of the following year