Club Membership Registration Form

Club Membership Application

Thank you for your interest in being part of our shared mission of service. Just complete the form below & someone will follow up with you.
Name

First Name(Preferred name or nickname)Last Name
Preferred E-mail (personal or work)
example@example.com
Cell Phone Number
Format: (000) 000-0000.
Home Phone Number
Format: (000) 000-0000.
Cell PhoneHome PhoneWork Phone (see below)
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birthdate (Month / Day/Year)
Spouse's Name
Anniversary Date
Children's Name(s) and Age(s)
Education
A Friend or colleaugeCurrent memberOne of our events or programsSocial mediaOther
KiwanisCircle KKey Club
Name of Club & (Departure Date)
Professional: Business Name
Professional: Business Phone Number
Professional: Email Address
Current or Retired Position / Title
YesNo
Kiwanis Sponsor's Name (if sponsored or invited by a club member):
Membership Information
1. A $60 application fee is required for to be considered for membership.

2. Club dues are $75 per quarter. These dues cover the administrative expenses of our club, Kiwanis District and Kiwanis International dues, and liability insurance for official Kiwanis / club activites or events and quartlery Kiwanis International magazines.

3. Meals are not included in quarterly dues; $10 per meal will be added to quarterly dues.
I have read, understood and accept the expectations for membership, as described above and on the club website (www.matthewskiwanis.org), and I happily request consideration for club membership.
Once you submit your application, we will contact you shortly to complete your membership consideration process.

Thank you again for joining us in service to others!
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Club Membership Application

Membership Information