Application Form

New Member Information Form

This field is for validation purposes and should be left unchanged.

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(Required)
(returning member whose name has changed)
Why do you want to join?
(check all that apply)

Contact Information

Prefix
Full legal name(Required)
Please include your Street, City, State/Province, & Postal code
Address Type
Phone Type
Email

Background Information

Number of children at home ages:
0-5
6-12
13-15
16-18
19-21
MM slash DD slash YYYY
MM slash DD slash YYYY
Primary employment
(check one, most recent employment if unemployed or retired)
(most recent if unemployed or retired)
Job classification
(check one)
Highest education attained
(check one)
Skillsets/Training
(check all that apply)

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By completing this application for membership, I agree to conform to the bylaws of this club & 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.
Clear Signature
MM slash DD slash YYYY
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