Membership Application
Lions Club Name
Member Sponsor
First Name
MI
Last Name
Suffix
Occupation
Address
City
State
Zip
Phone
Email
example@example.com
Spouse's Name
Signature
Shirt Size
Please Select
XSMALL
SMALL
MEDIUM
LARGE
XLARGE
My Products
prev
next
( X )
Jan 1 - March 31 New Member Dues
Includes Lions Club Shirt
$
120.00
Quantity
1
2
3
4
5
6
7
8
9
10
April 1 - June 30 New Member Dues
Includes Lions Club Shirt
$
98.50
Quantity
1
2
3
4
5
6
7
8
9
10
July 1,- Sept 30 New Member Dues
Includes Lions Club Shirt
$
77.50
Quantity
1
2
3
4
5
6
7
8
9
10
Oct 1 - Dec 31 New Member Dues
Includes Lions Club Shirt
$
56.25
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Preview PDF
Submit
Should be Empty: