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Kiwanis Membership Application
Kiwanis Club of West Covina, CA - Online Membership Application
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Email
*
Your email
Todays Date
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MM
/
DD
/
YYYY
Full Name
*
Your answer
Gender
Female
Male
Prefer not to say
Other:
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Date of birth
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MM
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DD
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YYYY
Spouse/ partner name
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Mailing Address
*
Your answer
City
*
Your answer
State
*
Your answer
Postal code
*
Your answer
Preferred phone
*
Your answer
Joining as
*
member
corporate member
Company name
Your answer
Are you a former Kiwanian?
*
Yes
No
Maybe
Are you a former K-Kids, Builder's Club, Key Clubber, KIWIN'S, and Circle-K
K-Kids
Builder's Club
Key Club
KIWIN'S
Circle-K
None of the above
Other:
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Who is the person that invited you to our Club?
Your answer
By providing my email address, I recognize that I am opting to receiving regular communication from Kiwanis International and West Covina Kiwanis
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No
Required
I accept this application for membership and agree to conform to the bylaws of this club and comply with the obligation of membership as explained to me by my sponsor. Type name below to represent digital signature.
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