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By checking 'Accept' below I confirm that I understand the contents of this form, that to the best of my knowledge my responses are true and that I hereby apply for membership in the Rotary Club of Fisantekraal.

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I hereby certify that if accepted to Membership of the Rotary Club of Fisantekraal, I, as a Rotarian, will exemplify the Object of Rotary in all my daily contacts and will abide by the constitutional documents of Rotary International and the club. I agree to pay an admission fee and dues in accordance with the bylaws of the club. *

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