Join Wellesley Kiwanis or Renew Your Membership

NEW MEMBER INFORMATION FORM
To help us support you, please provide the information below. We have clubs for every age and ability, but to become a member of Kiwanis you must be the legal age of adulthood in the state or country where the club is located.
Member type

New Kiwanis memberFormer Kiwanis memberCurrent Kiwanis memberTransferring Kiwanis memberHonorary Kiwanis memberCorporate Kiwanis memberFormer Service Leadership Program member
Former name (returning member whose name has changed)
Why do you want to join? (check all that apply)

To help kidsCommunity involvementBusiness networkingTo make friendsLeadership skills
Why do you want to join? (check all that apply)

OtherOther
Sponsor name(s)
Sponsor name(s)
Other

Prefix:M r.Mrs.Ms.Dr.Rev.NoneOther
Preferred
LAST/FAMILY
STREET
CITY
STATE/PROVINCE
POSTAL CODE
POSTAL CODE

homework
Phone
Format: (000) 000-0000.
Phone

homeworkcell
Email
example@example.com
Email

homework
Spouse/Partner name
Number of children at home ages: 0 -5
6 -12
12 - 15
15 - 18
19 - 21
Birthday MO. / DAY/ YEAR
Gender
Date joining club

MonthDayYear
Date
Languages spoken
Corporate boards or community groups you serve with or on
Corporate boards or community groups you serve with or on
Philanthropic interests or charities you donate to
Hobbies you enjoy
Primary employment (check one, most recent employment if unemployed or retired)

Agriculture/Forestry/FishingConstruction/ExtractionManufacturingHealthcareReal Estate/Property ManagementTransportation/WarehousingIT/TechBanking/Finance/InsuranceEducation/TrainingLegalNon-ProfitReligionWholesale/RetailFuneral/Death servicesCommunications/Media/MarketingGovernment/Public AdministrationHospitality/Food servicesMaintenanceScienceOtherOther
Name of current employer (most recent employer if unemployed or retired)
Name of current employer (most recent employer if unemployed or retired)
Job classification (check one)
Highest education attained (check one)

ElectedProfessionalTechnicalManagementSalesRetiredPartner/OwnerSupport/AdministrativeFreelance/Contract workOtherPrimary/Grade SchoolVocational/Trade schoolMasters DegreeSecondary/High SchoolAssoc. Degree 2 yrsGraduate/Professional DegreeTech/Business SchoolCollege/University 4 yrsOther
Degree(s) earned
Skill sets/Training (check all that apply)

Professional graphic designVideography/FilmPublic RelationsPhotographySocial mediaProfessional writing/editingStrategic planningCPA/AccountingFundraisingEvent planningYouth mentoringPolitical experienceGrant writingLegal degreeRecruitment
By completing this application for membership, I agree to conform to the bylaws of this club and comply with the obligations of membership as explained to me by my sponsor. In the United States, US$8 of a member’s annual dues and fees is applied to a Kiwanis magazine subscription. Additional membership dues and fees will be charged.
Date

MonthDayYear
Date
Thanks and welcome!
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NEW MEMBER INFORMATION FORM

Thanks and welcome!