CLUB RESERVATION FORM
Rotary Adventure in Citizenship Program 2020
APRIL 26 - APRIL 29, 2020

DEADLINE: DECEMBER 10, 2019


Please complete the form below and include all requested information.

After submitting your information, be sure to mail your cheque for $675 payable to the Rotary Club of Ottawa Charity Fund to:

Rotary Adventure in Citizenship Program
C/o Margot Nicholls
Box 553, 1748 South Russell Road
Russell, On K4R lE7

DEADLINE FOR RECEIPT OF RESERVATION AND CHEQUE (by mail)
DECEMBER 10, 2019

 

Contact Person (real name) *:
Address 1:
Address 2:
City:
Province: Postal Code: (example: H1H 1H1)
Telephone: (home)
(example: (xxx) xxx-xxxx)
Telephone:
(office)

(example: (xxx) xxx-xxxx)
Fax:
E-mail: *
   
Rotary Club of *:
   
Comments:

For more information, contact:

Margot Nicholls
Program Coordinator
Rotary Adventure in Citizenship Program
Phone: 613-860-1521
Fax: 613-445-6438
admin@rotaryottawa.com

 

www.RotaryOttawa.com

Registration