Membership Application


    Send club correspondence to:

    Check one block per category:

    Primary Employment:

    Job Classification:

    Education Attained:

    Membership Type:

    Were you in Key Club in high school or Circle K in college?

    Are you a former Kiwanian?


    I take pride in sponsoring as an active member of our club and have confi dence that this individual will become a valuable member

    (must be a current member)

    Additional Information

    If no member is sponsoring you, please provide three (3) references that we can contact:

    Reference 1:

    Reference 2:

    Reference 3: