Kiwanis Club
Want to Join!
Information Request Form

Please complete the following form if your would like to receive membership information about our Kiwanis Club and Kiwanis International. At the end of the form, please indicate how you would like the information sent (Electronic Mail, U.S. Mail, or a call from a member). 

* Name:
Address1:
Address2:
City:		State:
Zip/Postal:
Daytime Phone:
Evening Phone:
Fax:
* Email Address:
How would you like us to provide you information?
Mail Email Phone Fax
Are you interested in joining a Kiwanis Club?
Yes            No
Are you a member of another community service club?
Yes   No
If YES, indicate club name?

         

 

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