District Service Questionnaire

Dear Rotarian: In an effort to engage the many talents and passions of Rotarians throughout our District, we are interested in hearing form YOU about ways you would like to grow and serve at the District level. Please complete this brief questionnaire by May 19th. Thank you in advance for your willingness to share your time and talents with us! Thank you for your feedback! Questions or Comments? Reach out to Melissa Kopp-Smith at office@rotary7390.org  or 717-854-7842. 
1.Name(Required.)
2.Email Address(Required.)
3.Club Name(Required.)
4.Current title and place of work if employed
5.Name of Rotary Fellowship(s) you are involved in (if applicable)
6.Name of Rotary Actions Group(s) you are involved in (if applicable)
7.Name of District Committees or activities you are currently involved in
8.Passions and skills you would be willing to share on a District level
9.Current or Past Leadership Roles in Rotary
10.Causes, Committees, and events you might be interested in exploring or participating in (Check all that apply) in the next few questions! Have a passion or interest that isn't mentioned below? Let us know! We are open to new ideas and ways to serve our Clubs!
11.Rotary Focus Areas
12.The Rotary Foundation Activities
13.Youth Activities
14.Rotary Education
15.District Operations
16.Other