NEW MEMBERSHIP FORM

NEW MEMBERSHIP FORM

Kiwanis Club of Gillette
Name:*

First NameLast Name
Email:*
example@example.com
Date of Birth:*

MonthDayYear
Date
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Membership Type:*
Why do you want to join?*

To Help KidsCommunity InvolvementBusiness NetworkingTo Make FriendsLeadership SkillsOther
Sponsor Name(s):*
GETTING TO KNOW YOU
Spouse/Partner Name:

First NameLast Name
Number of children at home:
Languages Spoken:
Corporate Boards or Community Groups you serve with or on:
Philanthropic interest or charities you donate to:
Hobbies you enjoy:
Name of Current Employer (or most recent):*
Highest Education Attained:
Special Skill Sets/Training:
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.
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Date*

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Date
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GETTING TO KNOW YOU