Hialeah gardens key club application

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Hialeah gardens key club application

  1. 1. Hialeah Gardens Key Club New Membership Application 2012-2013 Section I: Contact Information Name______________________________________________________________ Student I.D.#____________Grade:_____ Date of Birth: ___________________ Address:___________________ City/State:_________________Zip Code_______ Cell Phone #:_______________________________ Can you receive text messages? ___yes ___no Home phone #:_____________________________ Email: ____________________________________ UnweightedGPA: _____________________________________ Class of: ______2013 _____2014 _____2015______ 2016 *Check in front of graduating year. Schedule Period Subject Teacher Room #1
  2. 2. Hialeah Gardens Key Club Section II: Questionnaire What organizations do you now belong or have belonged to? Please list any offices you have held. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Have you received any honors or special achievements? Please list them. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ What out-of-school activities do you currently participate in? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Why do you want to join Key Club? What can you contribute if you join? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________2
  3. 3. Hialeah Gardens Key Club Are you able to attend our weekly lunch meetings? Yes_________ No_________ Do you have transportation to/from projects and events? Yes_________ No_________ Do you drive and own a car? Yes____ No____ Would you be able to drive a car pool to some projects? Yes________ No_______ Are you willing to participate in the required monthly fundraiser? Yes___ No____ Are you willing to attend fundraisers for Kiwanis and not receive service hours to contribute to the bettering of the organization? Yes_______ No________ Do you have a friend[s] that would like to join Key Club? [Write first & last name] ___________________________________________________________________ ___________________________________________________________________ Did someone invite you to join Key Club? [Is so give his/her full name?] ___________________________________________________________________ Section III: Key Club Pledge I pledge on my honor to uphold the objects of Key Club International; to build my home, school, and community, to serve my nation and God; and to combat all forces that tend to undermine these institutions. X__________________________________________________________________3
  4. 4. Hialeah Gardens Key Club Section IV: Membership Contract As a member of the Key Club of Hialeah Gardens High School, I will attend all meetings and participate in all club activities.I will earn at least 10 community service hours per month, including the summer. I will participate in all required projects, including all fundraising activities, or complete make-up work as approved by the Board of Directors.I will abide by the Key Club pledge and will be a good representative of my club, school, and community.Also, I will complete a 30 hour probation period before October 1, 2012 with Key Club before I’m a member. Failure to abide by these terms will result in probation and ultimately termination from the club. X__________________________________________________________________ Prospective Member Signature ________________________ Date Signed My son/daughter has my permission to join the Key Club of Hialeah Gardens High School. I will allow my son/daughter to attend lunch meetings on Wednesdays.I understand that my son/daughter will participate in many community service projects on the weekends and—on occasion—during the week.I also understand that he/she will be responsible for participating in fundraising activities to raise money for the club. I further understand that I must participate in at least one peanut day or car wash as a supervisor during this Key Club year. I fully understand that transportation is not provided, I must provide transportation. X_______________________________________________________________ Legal Guardian Signature ___________________ Date Signed4
  5. 5. Hialeah Gardens Key Club Section V: New Prospective Seniors ONLY *If you are a graduating this year and a returning member to Key Club this does NOT apply to you! As a senior at Hialeah Gardens High School and a prospective member I understand that I need to complete 10 hours each month even after the service hour cutoff date in December to graduate. As a prospective member of Key Club as a senior I also understand that I must complete a30 hourprobation period with Key Club before October 1stto become a member. X_______________________________________________________________ Prospective Senior Signature5
  6. 6. Section VI: Office Use Only Date Application Submitted: _____________________ Date Dues Paid: _____________________ Grade Point Average: _____________________ Date Financial Obligations Checked: _____________________ Results of Financial Obl. Check: _____________________________________________________________________________________________ _____________________________________________________________________________________________ Date of Board Approval: _____________________ Date of Board Rejection: _____________________ Reason for Rejection: _____________________________________________________________________________________________ _____________________________________________________________________________________________ Date Inducted: _____________________ Certificate Presented? _____________________ Pin Presented? _____________________ Chair’s Signature: _____________________________________________________________________________________________6

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