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DOWNLOAD New Membership Application PDF
or fill out the form below.
Scroll down to Sponsorship Application for New Member
MEMBERSHIP APPLICATION
Kiwanis Membership Application
Personal
Full Name
*
Nickname
Gender
*
Home Address
*
Home Address
Home Address
Home Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Home Phone
*
Spouse/Partner Name
Email
Date of Birth
*
Business
Company Name
Title
Business Address
Business Address
Business Address
Business Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Business Phone
Fax
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Home
Work
If Former Kiwanian
Club Name
Date Left
Length of Membership
Life Member #
Check One Block per Category
Primary Employment
*
1-Banking/Finance
3-Comm/Media
5-Construction
7-Education
9-Government
11-Legal
13-Mfg (Heavy)
15-Mfg (Light)
17-Medical
19-Nonprofit
21-Real Estate
23-Religion
25-Retail
27-Transportation
29-Wholesale
94-Other
94-Other
Job Classification
*
N-Elected
O-Management
P-Partner/Owner
Q-Professional
R-Sales
S-Supervision
T-Technical
V-Retired
X-Other
X-Other
Education Attained
*
A-Grade School
B-High School
C-Tech. Business School
D-Assoc Degree (2yr)
E-Baccalaureate (4yr)
F-Masters Degree
G-Grad. Prof. Degree
For membership statistics only. Kiwanis International does not provide its membership information to third parties.
Accept Terms
I accept this application for membership and agree to conform to the bylaws of this club and
comply with the obligations of membership as explained to me by my sponsor.
Today's Date
Applicanat Signature
*
New Member Sponsor
Sponsor Name
Please have your Sponsor fill out the New Member Sponsor Form
Submit
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DOWNLOAD New Member Sponsor Form PDF
or fill out the form below.
NEW MEMBER SPONSOR FORM
New Membership Sponsor
New Member Sponsor
To the Board of Directors of the Kiwanis Club of Safety Harbor,
I take pride in proposing
Name
as an active member of the club and have confidence that this individual will become a valuable member.
Date
Sponsor Signature
Sponsor Name
Additional Club Member
Recommended by Membership Committee
Date
Chairman Signature
Membership Class
Suggested Classification
Elected to Membership by Board of Directors:
Date
Secretary Signature
Member Accomplishments
Total Years of Perfect Attendance
Offices Held
Awards
If you are human, leave this field blank.
Submit
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