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Membership Application
Kiwanis Club of Mission Viejo
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Email
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Your email
Full Name
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Nickname
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Gender
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Other:
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Date of birth
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/
DD
/
YYYY
Spouse/ partner name
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Primary Address
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City
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State
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Postal code
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Preferred phone
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Email
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Joining as
member
corporate member
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Company name
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By providing my email address, I recognize that I am opting to receiving regular communication from Kiwanis International.
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Are you a former Kiwanian?
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No
Maybe
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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
Other:
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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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