New Member Application

Application for new club member to fill out and submit

Name
Email
Date of Birth
Anniversary Date
Home Address
Business Address
Primary Employment (check only one)
Note: for membership statistics only. Kiwanis International does not provide it’s membership information to third parties.
Job Classification (check only one)
Note: for membership statistics only. Kiwanis International does not provide it’s membership information to third parties.
Education Attained (check only one)
Note: for membership statistics only. Kiwanis International does not provide it’s membership information to third parties.
Committee Preference (check only one)
The Kiwanis year runs from October 1st-September 30th. The cost for current members is $190. The cost for new members is prorated by the month that you join. Please select correct month. A surcharge of 3% has been added to your total when paying by credit card, which is not greater than our cost of acceptance. This charge does not apply when paying by check.
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