Kiwanis Membership Application
Thank you for your interest in joining our club! We are happy to have you join us. Please email lapuentekiwanis@gmail.com for any questions.
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Full Name *
Nickname
Date of Birth *
MM
/
DD
/
YYYY
Email Address *
By providing your email address, you recognize that you are opting to receive regular communication from Kiwanis International.
Preferred Mailing Address *
City *
State *
Zip Code *
Preferred Phone Number *
Joining as *
Name of Company (if corporate member)
If you are a current/former Kiwanian, please list the name of the club(s) below
Are you a former K-Kids, Builders Club, Key Club, KIWIN'S, or Circle-K member?
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 including payment of annual dues. Annual current membership dues are $170. In the United States, $8 of a member’s annual dues and fees is applied to a Kiwanis magazine subscription. Payment plans and sponsorships are available. Please speak with a board member for more details.
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