Metro Detroit Young Professionals Kiwanis Membership Form
Your membership form has been submitted. Make your dues ( $125) payable to Metro Detroit YP Kiwanis.
If you were a member of Circle K in the past you may be eligible for reduced dues your first year!

Any questions? Email metrodetroitypkiwanis@gmail.com
First Name *
Middle Name
Last Name *
Nickname
Gender *
Date of Birth *
We may have a birthday surprise for you!
MM
/
DD
/
YYYY
Spouse/Partner Name
Home Address *
City *
State *
Postal Code *
Phone Number *
Email *
By providing my email address, I recognize that I am opting in to receive regular communication from Kiwanis International.
Company Name *
Job Title
Sponsor
If someone invited you or told you about our club, whether it be a project or meeting or otherwise, please provide their name here
Are you a former Kiwanian? *
If yes, club name?
Date left Kiwanis
(month, year)
Length of membership
(months/years)
If you are a life member, life member #
How did you hear about us? *
Do you have any service project ideas you have or any agencies you would like to work with? *
What type of socials would you like to see us do? *
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