Membership Application Form

Membership Application Form

Lions Club of Runaway Bay
Name*

First NameLast Name
Gender*
Date of Birth *
Partner Name

First NameLast Name
Occupation
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Lions Club Sponsor Name
Application Fee - $25 and Semi Annual Fee $45. Amount Paid*
I accept membership into Lions Club International and that the standards are limited to persons of good moral character and reputation. I recognise the importance of rendering personal service to my community in cooperation with other civic-minded persons. I understand that membership is not valid until approved by the Club Board of Directors.
Please verify that you are human*
Should be Empty: