About Us
Membership
Programs & Events
Contact

About Us
Membership
Programs & Events
Contact

Membership Application

Join the club

Fill out the form and start making an impact on children’s lives!

Full name:*

Title

First

Last

Middle

Nickname:

Gender:*

Date of birth (MM/DD/YYYY):*

Spouse/partner name:

Title

First

Last

Middle

Home address:*

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

Preferred phone number:*

Area Code

-

Phone Number

Company name:

Title in company

By providing my email, I recognize that I am opting in to receiving regular communication from Kiwanis International.

E-mail:

Send Kiwanis mail to:*

Home

Business

By email

Member sponsor name:

Title

First

Last

Middle

Member ID:

Committee preference:

Programs

Service & Fundraising

Membership

Financial review

Are you a former Kiwanian?*

Yes

No

Are you a former Key Club or CKI member?*

Yes

No

If yes, Club name(s):

I accept this application for membership and agree to conform to the bylaws of the San Gabriel Kiwanis Club and comply with the obligations of membership as explained to me by my sponsor.

Applicant digital signature (type your full name):*

Today's date (MM/DD/YYYY):*

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