Kiwanis Club Membership Information Request Form

Elkhorn Kiwanis Club
POB 553
Elkhorn, WI 53121
Attn: Membership Chair

Please complete the following form if you 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).

First Name:    
Middle Name:   
Last Name:     
Address1:      
Address2:      
City           
State          
Zip/Postal     
Country:       
Daytime Phone: 
Evening Phone: 
Fax Phone:     
Email Address: 

How would you like us to provide you information?
Surface Mail    
Telephone       
Email           

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?  
Enter Comments Below:

© Copyright 1995 Kiwanis Club of Palo Alto, CA. / Property (1997-98) of Elkhorn Kiwanis Club - Elkhorn, Wisconsin.