Kiwanis Club Membership Form

Gender*

Male Female

Complete Address with Zip/Postal Code.

Send Kiwanis mail to:*

Home Work

If you are a former Kiwanian:*

Date of Birth:*

I accept this application for membership and agree to confirm to the bylaws of this club and comply with the obligations of membership as explained to me by the sponsor.

Committe Preference*

Club Administration Community Service

Date

Applicant Signature*

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To the Board of Directors of the Kiwanis Club

I take pride in proposing

as an active member of the club and have confidence that this individual will become a valuable member.

Date

Sponsor Name:

Sponsor Signature*

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Additional Club Member

Date:

Chairman Signature

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Membership Class:*

Suggested Classification:

Date

Secretary Signature

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Total Years of Perfact Attendance

Offices Held:

Awards:

New Member Sponsor:

Recommended by Membership Committe:

Elected To Membership by Board of Directors:

Member Accomplishments: