Acceptable file formats: .jpg .jpeg .png .gif File size must be less than 2MB. Please upload a photo of yourself. Any photo will do, but the closer the photo is to your face, the better. We can crop any photo down to the appropriate size if you don't know how to do it. If you don't have access to a photo or are having problems uploading, you can skip this and just e-mail a photo to firstname.lastname@example.org
Have you ever been charged with, been convicted of, or pleaded guilty to any crime? Yes
Have you ever been subject to any court order (including an order from a civil, family, or criminal court) that involved sexual, physical, or verbal abuse, including but not limited to domestic violence or civil harassment injunctions or protective orders?
The district strives to create and maintain a safe environment for all youth who participate in Rotary activities. To the best of their ability, Rotarians, Rotarians’ spouses and partners, and other volunteers must safeguard the children and young people they come into contact with and protect them from physical, sexual,
and psychological abuse.
The information you provide may be given to an agency that this Rotary district has hired to conduct background checks. In other cases, applicants may be asked to obtain their own background checks for review by district officials.