Name: __________________________________________________
Address_________________________________________________
City_____________________________________________________
State____________________________________________________
Zip Code_________________________________________________
Country__________________________________________________
Email Address____________________________________________
Telephone________________________________________________

Please make your check out to: 
Rotary Global History Fellowship

Mail it to:    
Geri Appel, Treasurer  
1668 N Sagebrush  
Wichita, KS 67230  

E-mail: appelg@kenlerman.com