Become a Kiwanis Member

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, province or country where the club is located.

Former Name (returning member whose name has changed)

If other, please specify:

Sponsor name(s):

Contact Information

If prefix is other, please specify:

Your Phone

Background Information

Spouse/Partner name

Ages of children at home (if any)

Number of children 0-5yrs

Number of children 6-12yrs

Number of children 13-15yrs

Number of children 16-18yrs

Number of children 19-21yrs

Your birthdate

Date joining club*

Languages Spoken

Corporate boards or community groups you serve with or on

Philanthropic interests or charities you donate to

Hobbies you enjoy

Name of current employer (most recent employer if unemployed or retired)

Degree(s) earned

Signature*

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, $8USD of a members annual dues and fees is applied to a Kiwanis magazine subscription. Additional membership dues and fees will be charged.

Date Signed

Membership Application

New Member Information Form

Contact Information

Background Information

Ages of children at home (if any)