Online Membership Application

Name*

First Last

Mailing Address (street, city, state zip code)*

Please enter street, city, state and zip code)

Email (Preferred)*

Phone number (Preferred)*

Date of Birth*

Sponsor Name*

First Last

Member Type*

Why do you want to join the Kiwanis Club of Williamsburg (Check all that apply)*

Date you wish to start your membership

Club meetings I will be attending

Weekly Wednesday lunches

Monthly Satellite Committee Meetings

Which committee(s) would you like to join?

Public Relations and Marketing*

Kiwanogram

Print & Social Media

Service Leadership Programs*

Key Club – Walsingham

Key Club – Jamestown

Key Club – Lafayette

CKI – Williams & Mary

Employer Name, Address, Phone, and Brief Job Description

Spouse/Partner Name

Number of children at home and their ages

Please enter a number from 0 to 100.

This information is helpful for planning club family social events

Languages Spoken

Hobbies you enjoy and any special skill sets you would like to mention

Membership on Corporate Boards or in Community organizations

Membership Agreement*

By completing this application for membership, I agree to conform to the bylaws of this club and comply with the obligations of membership as detailed here: International and District Dues of $117 per year. Club Dues of $21 per month ($252 per year). For each weekly luncheon meeting that I RSVP for as attending, I will be billed $26.40. If you have questions, please refer to your sponsor or email info@williamsburgkiwanis.org.

Initials*

Application Submission Date*

Email*

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Kiwanis

Fund Raising Events

Kiwanis Supports

Membership