Applicant Form

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Applicant Form

Applicant Form

Select District Code*

Please select a district code to proceed.

Mobile Number * The mobile number already exists in our records. Your information is already saved with us. Please enter a valid mobile number.

Full Name * Full Name is required.

Email * Valid Email is required.

Post Held in District

Post Held in Club

Rotary Club Name and ID

Passport Number Invalid passport number

Age

Classification

List a couple of your interests/hobbies

List any medications you might need

Please tell us anything else we should know to make sure your visit is as comfortable as possible.

About You

Your Photo *

Uploaded Photo

Uploaded Photo

Uploaded Photo

Photo is required.

Crop Your Photo

Gender

Male
Female

Accompanied by Spouse / Partner ?

Yes
No

Drink Alcohol

Yes
No

Vegetarian

Yes
No

Do You Smoke

Yes
No

Any Problem with Household Pets?

Yes
No

T-Shirt Size

S

M

L

XL

XXL

Preferred Breakfast Items

Eggs

Pancakes

Fruit

Cereal

Yogurt

How do you want to become part of the Exchange ?

I Want to Host Guests Only at my Home

I Want to Host and Also Want to Visit Other Countries

If You Want to Host, Please Provide the Following Details

I have a bedroom with an attached toilet for the incoming guests

I have household pets

Who Else is in Your Family?

I live with my Wife and Kids

I live Alone

I live along with my parents

Can You Host the Guests with Alcohol?

Yes No

Do You Have a Smoke Area in Your Home for the Guests?

Yes No

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