Rotary News Survey Name: * Rotary Club: * RI District: * Mobile number: * Email: * Choose which issues of 2020/21 have been received: * Jan 2021: Received Not Received Do not remember Feb 2021: Received Not Received Do not remember Mar 2021: Received Not Received Do not remember Apr 2021: Received Not Received Do not remember May 2021: Received Not Received Do not remember Jun 2021: Received Not Received Do not remember Jul 2021: Received Not Received Do not remember Aug 2021: Received Not Received Do not remember Sep 2021: Received Not Received Do not remember Oct 2021: Received Not Received Do not remember Nov 2021: Received Not Received Do not remember Address line 1: Address line 2: City: State: Pincode: Phone number: *fields are required Δ