Ashland Kiwanis Club Membership Application

Kiwanis Club of Ashland, OH

Thank you for your interest in joining the Ashland Kiwanis Club! Through Kiwanis membership, individuals can give of themselves, their talent, time and love to those in need in our community while forming lifetime friendships.

Please complete the application below and a Kiwanis member will in touch with once we have reviewed your application.

PERSONAL INFORMATION

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* 1. First Name

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* 2. Last Name

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* 3. Date of Birth (Month/Day)

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* 4. Home Address

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* 5. City

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* 6. State

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* 7. Zip Code

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* 8. Cell Phone Number

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* 9. Home Phone Number:

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* 10. Email Address

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* 11. Spouse's Name

EMPLOYER INFORMATION

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* 12. Business or Firm Name

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* 13. Business Phone Number

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* 14. Business Address

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* 15. City

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* 16. State

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* 17. Zip Code

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* 18. Preferred Mailing Address

Home

Business

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* 19. If you are a former Kiwanian, please provide us with the club name, city and state

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* 20. Who is your Ashland Kiwanis Sponsor or current member that encouraged you to join?