Charter Member Application

CHARTER MEMEBR APPLICATION & PAYMENT FORM

Welcome to the formation of our new Kiwanis Club! This form serves as both the official membership application and the means to collect initial charter member dues. By completing this form, you are joining a global network of community-minded volunteers dedicated to improving the world—one child and one community at a time. Please provide accurate contact and background information to help us complete your Kiwanis International membership record. The information you share will be used to: Register you as a charter member of the new club Submit your membership to Kiwanis International for official chartering Collect your initial dues and fees, which cover international, district, and local club membership requirements Your submission confirms your intent to become an active charter member committed to serving children and communities through Kiwanis.

Name
Address
MM slash DD slash YYYY
SPONSOR
ARE YOU A…

PAYMENT INFO

Please enter the Charter Memebr Dues Total using the following format- $150.00
Text