If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required CLUB REGISTRATION APPLICATION FOR 2019 ADVENTURE IN HIGH TECHNOLOGY Hosted by the Rotary Club of Nepean-Kanata  Sponsoring Rotary Club Name * Program Coordinator’s Name * Address: Town, Province, Postal Code * Telephone: * e - Mail ... : * Signature: (Print Name and Date) * *****Enclose Application Fee of $350.00 (CDN)***** Please make checks payable to the Rotary Club of Nepean-Kanata SUNDAY, OCTOBER 20 TO THURSDAY, OCTOBER 24, 2019 SUBMIT APPLICATION BY October 14 VISIT OUR WEBSITE www.nepeankanatarotary.org AND FOLLOW THE LINK UNDER WHAT WE DO TO THE 2019 ADVENTURE IN HI-TECH