Want to become a member of the Utica-Shelby club? Fill out the application form to begin the process. "*" indicates required fields Full name*Preferred nameGenderDate of birth MM slash DD slash YYYY Spouse/Partner namePrimary address*City*State/province*Postal code*Preferred phonePhone type home work cell Email* Joining as Individual Membership Corporate Membership Company nameBy providing my email address, I recognize that I am opting to receive regular communication from Kiwanis International.InitialDate (month/year) MM slash DD slash YYYY Member sponsor name:*Member ID:Club name:Committee preference: Programs Service & fundraising Membership Financial review Are you a former Kiwanian? Yes No Are you a former K-Kids, Builders Club, Key Club or CKI member? Yes No If yes, club name(s)In the U.S., $8 of a member’s annual dues and fees are applied to the official publications of Kiwanis International.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.Applicant signature*Date (month/year) MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged. Δ