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District 6910 Opioid Operations
Committee Application
Name
First
Last
Email
Phone
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Rotary Club
Years in Rotary
Professional Background
Rotary Leadership Roles (if any)
Statement of interest
Please answer the following with a few paragraphs below.
1. Why do you want to serve on the Rotary District 6910 Opioid Settlement Operations Committee?
2. What skills, experiences, or perspectives do you bring to this role?
3. How do you see Rotary making a difference in the fight against the opioid crisis?
4. What strategies do you believe will ensure fair and effective distribution of these funds?
Letter of Support
Each applicant must upload a Letter of Support from their Rotary Club President confirming:
1. The Applicant is in Good Standing within the club.
2. The Applicant's commitment to fulfilling committee responsibilities.
3. The Club's endorsement of the applicant as a representative for this committee.
Commitment Agreement
By signing below, I confirm that:
1. I understand the responsibilities of serving on this committee.
2. I am available to participate in regular meetings *virtual/in-person
3. I will act with integrity, impartiality, and in alignment with Rotary's mission.
Signature
Clear
