test Please enable JavaScript in your browser to complete this form. - Step 1 of 4Applicant InformationThis information is required to enter you into our district database if your application is accepted.Name *FirstLastCompany Name / EmployerAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePositionEmail *Mobile Phone *How do you prefer to be contacted? (Select all that apply) *EmailPhoneText messageIndustry Category *--- Select Choice ---Air TransportationCustoms BrokerFinancial ServicesFreight ForwarderGovernmentInsurance CompanyLogistics ProviderMarine TransportationOtherRail TransportationResearch OrganizationRoad TransportationService ProviderNextAdditional Individuals to be Included in the Corporate MembershipNameFirstLastEmailNameFirstLastEmail Shall be Additional NameFirstLastEmailNameFirstLastEmailNameFirstLastEmailNameFirstLastEmailNameFirstLastEmailWTC & YouThis section will help us learn a bit more about your interest in Rotary.How did you hear about us? (Select all that apply) *From a current or past memberAttended a fundraising event in the communitySearch engine results while researching volunteer/community organizationsWebsiteSocial MediaOtherOther (please specify):Name of the person who referred youWhich social media profiles?FacebookInstagramLinkedInYouTubeNextThe Following Shall Be Eligible for Membership *I agree to the terms below.Companies and Individuals that represent any one or more of the following areas: transport goods by highway, air, rail or water; logistic providers; freight forwarders; custom brokers; insurance companies; government agencies, and/or transportation service companies.Privacy *I agree to the terms below.By submitting this form, you are consenting to receive emails from the Windsor Transportation Club. You can revoke your consent to receive emails at any time by contacting the Windsor Transportation Club via its general inbox at member@windsortransportationclub.com. By providing WTC with your personal information on this membership form, you are giving consent to the WTC to collect and use your personal information for the purposes as set out in the WTC Privacy Policy. https://windsortransportationclub.com/privacy-policy-2/Waiver and Indemnity *I agree to the terms below.In consideration of being admitted to membership in the Windsor Transportation Club, I hereby waive any claims and causes of action that I may in future have or acquire against the Windsor Transportation Club, its Officers and Directors, for personal injury, death or damage or destruction to property, arising out of my attendance or participation in any meeting, function or event conducted, sponsored or organized by or on behalf of the Windsor Transportation Club, whether by negligence or otherwise. I further agree to indemnify and save harmless the Windsor Transportation Club, its Officers and Directors, from any such claims and causes of action that may be acquired by anyone invited or attending such meeting, function or event as my guest.NextUpdating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes. By submitting this form you are agreeing to the terms listed. Submitting this application will indicated the same as your digital signature.Total Order Summary Item Quantity Qty Total There are no products selected. Total$0.00 $0.00SquareCardName on CardPreviousSubmit
