Georgia Kiwanis New Club Charter Member online processing portal 21-22
*
Required information
Personal Information
*
First Name:
*
Last Name:
*
Email Address:
*
Confirm Email Address:
*
Address 1:
Address 2:
Address 3:
*
City:
*
State:
--Choose--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
--------------
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
*
ZIP Code:
*
Phone:
Cell Phone:
Spouse/Partner Name
*
Date of Birth
Promo Code
Enter Code:
Apply
Fee
Type
Fee
New Charter Fee
$
135.00
Business Information
Company:
Job Title:
Address 1:
Address 2:
Address 3:
City:
State:
--Choose--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
--------------
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
ZIP Code:
Fax:
*
Which address do you want your Kiwanis Mail to be sent?
Home
Work
*
Do you hereby agree to 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?
Yes
No
Optional Information
Do you have a Nickname you wish to include with the your membership Application
Do you have a club committee preference?
Administrative
Community Service
Sponsor Information
*
Please write the name of the Kiwanian who is sponsoring you for membership?
Club You are Joining and Membership Type
Which new chartering Kiwanis club are you joining?
What type of club membership are you applying for?
Regular
Corporate
$
9,999.99
Payment
Payment Method
Pay with Credit Card
Payment Summary
Emails are serviced by Constant Contact.
Register
You will be taken to ProPay to complete payment.
Continue
You will be taken to PayPal to complete payment.
No PayPal account is required.
Mobile View
Desktop View
2021-10-27T13:00:00-0400
2022-11-15T13:00:00-0500
Georgia Kiwanis New Club Charter Member online processing portal 21-22
4875 Riverside Drive, Suite 204, Macon, GA, 31210, US
http://events.r20.constantcontact.com/register/event?llr=8q7lrspab&oeidk=a07eiqdf0nw74d9981e