Membership

Join us to help make a positive difference in the lives of local children and their families!

Southlake Kiwanis has been recognized as one of the fastest-growing club for the past two years.

New Member Information Form

Personal Information
Name*
First Last
Nickname
Gender*
Date of birth (mo/day/yr)
Date Format: MM slash DD slash YYYY
Address
Street Address City State ZIP Code
Phone*
Spouse/Partner Name
Business Information
Company Name
Title
Business Address
Street Address City State ZIP Code
Business Phone
Fax Number
Email Address*
Send Kiwanis mail to
If you are a former Kiwanian
Club Name
Date left (mo/day/yr)
Date Format: MM slash DD slash YYYY
Length of membership
Other Information
If you are a life member, life member #
Committee preference
I accept this application for membership and agree to conform to the bylaws of this club and comply with the obligations of membership as explained to me by my sponsor. In the U.S., US $8 of a member's annual dues and fees is applied to a Kiwanis magazine subscription.
Date*
Date Format: MM slash DD slash YYYY
Comments
This field is for validation purposes and should be left unchanged.