Join the Kiwanis Club of Greater Ybor City
Membership Application for the Kiwanis Club of Greater Ybor City
First Name *
Middle Name or Initial
Last Name *
Nickname
Street Address *
City, State *
Zip Code *
Work Phone
Home Phone
Cell Phone
Work Email Address
Personal Email Address
Profession *
Were you in an SLP? (Verified SLP get a dues discount. Check all that apply) *
Required
Kiwanis Sponsor (If none, enter None) *
Birthdate *
MM
/
DD
/
YYYY
Gender
Highest Education Level *
Areas of Interest (Check all that apply) *
Required
Do you agree to pay the Membership Application Fee ($100 total = $50 Kiwanis International + $25 FL District + $25 Greater Ybor City Kiwanis) and $150 annual member dues to maintain your membership in good standing in subsequent years? Former SLP only pay $25 club fees. *
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