866-880-5160 • Contact Form
Rotary District 5160

Request a Website

Items appearing in RED are required.



Please indicate who is completing this form.


Your Name

Your Email

Your Phone


Please complete the requested information about the club.

Club Name

Club Number

Who will be the club website administrator?
    Name:  
    Email:  
    Phone:  

Does this club already have a website?

If this club ALREADY has a website, what is the domain name (e.g. albanyrotary.org)?

If this club DOESN'T have a website yet, is there a domain name that is being considered or has already been registered?


Please use this space for any additional comments, requests or questions.

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