Kiwanis New Club Information Sheet
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Warning: Do not use parentheses, "(" or ")" on
this form, it will cause your information not to be received |
NEW CLUB INFORMATION:
Organization Date:
Kiwanis Club of:
Located in City:
State/Province:
Country:
Principle language:
District:
Division Number:
LT. GOVERNOR
Name:
Address:
City:
State/Province:
ZIP/Postal Code:
Country:
TAG TEAM MEMBER (Your
information)
Name:
Business Phone:
Home Phone:
E-mail (required):
Number of Members in the Club:
CLUB PRESIDENT
Ms.
Mr.
Mrs.
Dr.
Other:
Name:
Address:
City:
State/Province:
ZIP/Postal Code:
Country:
Business Phone:
Home Phone:
Fax:
E-mail:
CLUB SECRETARY
Ms.
Mr.
Mrs.
Dr.
Other:
Name:
Address:
City:
State/Province:
ZIP/Postal Code:
Country:
Business Phone:
Home Phone:
Fax:
E-mail:
Meeting Day:
Meeting Time:
Meeting Place:
Street Address:
City:
State/Province:
ZIP/Postal Code:
Country:
Sponsoring Kiwanis Club(s):
(provide club names and club key numbers, if known)
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