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Key number: (for office use only)
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Form must be completed for chartering to be processed. Please submit electronically to slpcharter@kiwanis.org.
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Club information
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Club name:
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School/club address:
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State/Province:
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Postal Code
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Country:
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District:
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Kiwanis advisor name:
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Kiwanis advisor e-mail:
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Advisor name:
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Advisor e-mail:
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Charter members information
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*Please provide all information allowed by school/agency policy.
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Last nameFirst Name Graduation year Gender Email Address
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President
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Vice president
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Secretary
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Treasurer
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Editor
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Webmaster
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Last nameFirst Name Graduation year Gender Email Address
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Last nameFirst Name Graduation year Gender Email Address
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