Fillable NEW MEMBER INFORMATION FORM

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NEW MEMBER INFORMATION FORM

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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 or country where the club is located.
Member type*
New Kiwanis member Former Kiwanis member Current Kiwanis member Transferring Kiwanis member
Honorary Kiwanis member Corporate Kiwanis member Former Service Leadership Program member
Former name (returning member whose name has changed) _________________________________________________________
Why do you want to join? (check all that apply)
To help kids Community involvement Business networking To make friends Leadership skills
Other ____________________________________________________________________________________________________
Sponsor name(s) ________________________________________________________________________________________
____________________________________________________________________________________________________________
Contact information
Prex: Mr. Mrs. Ms. Dr. Rev. None Other ________________________________________________
Full legal name* ________________________________________________________________ Preferred _____________________
LAST/FAMILY FIRST/GIVEN MIDDLE
Preferred mailing address* _____________________________________________________________________________________
STREET
_____________________________________________________________________________________________ home work
CITY STATE/PROVINCE POSTAL CODE
Phone ________________________________________________________________________________ home work cell
Email _______________________________________________________________________________________ home work
Background information
Spouse/Partner name _________________________________________________________________________________________
Number of children at home ages: 0-5 __________ 6 -12 __________ 12 -15____________ 15 - 18 ___________19 - 21 __________
Birthday MO. / DAY/ YEAR _________________________ Gender ______________ 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 ____________________________________________________________________________________________
*REQUIRED
Primary employment (check one, most recent employment if unemployed or retired)
Agriculture/Forestry/Fishing Banking/Finance/Insurance Communications/Media/Marketing
Construction/Extraction Education/Training Government/Public Administration
Manufacturing Legal Hospitality/Food services
Healthcare Non-Prot Maintenance
Real Estate/Property Management Religion Science
Transportation/Warehousing Wholesale/Retail Other ____________________________
IT/Tech Funeral/Death services ____________________________________
Name of current employer (most recent employer if unemployed or retired) _____________________________________________
____________________________________________________________________________________________________________
Job classication (check one)
Elected Sales Freelance/Contract work
Professional Retired
Technical Partner/Owner
Other ____________________________
Management Support/Administrative ____________________________________
Highest education attained (check one)
Primary/Grade School Secondary/High School Tech/Business School
Vocational/Trade school Assoc. Degree (2 yrs.) College/University (4 yrs.)
Masters Degree Graduate/Professional Degree
Degree(s) earned _____________________________________________________________________________________________
Skill sets/Training (check all that apply)
Professional graphic design Videography/Film Public Relations
Photography Social media Professional writing/editing
Strategic planning CPA/Accounting Fundraising
Event planning Youth mentoring Political experience
Grant writing Legal degree Recruitment
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.
Signature* _____________________________________________________________________ Date _________________________
*REQUIRED
Thanks and welcome!
GIGR-1018-548
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NEW MEMBER INFORMATION FORM

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Completed 10 July 2022

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