Membership Contract

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Membership Contract

  1. 1. Full Name:First Middle LastLocal Contact Information:Email: Phone Number: (____)____-______ Include area code!Year: FR SO JR SR+ Major:Birthday: Sex: Where are you F M you from?Emergency Contact Information: Carpool Information:Name of Contact: Do you have a car? Yes NoPhone: Would you be willingRelationship: to drive to events? Yes NoFamily Interests:Are you interested in being a part of one of our five families?Yes, I d like to be a Part of a family! No, I do not wish to be in a family!Membership:How did you hear about Circle K?Have you been in a Kiwanis organization before? (i.e. KEY Club) I am enclosing $30 for my membership dues which includes a T-Shirt of the following size: Small Medium Large Extra-LargeBy submitting this contract, I verify that I am a member of Circle K International, and I will abide by the rulesand regulations of our organization.Member Signature: __________________________________________ Date Paid: __________________For Official Use Only:President Signature: _____________________________ Treasurer Signature: _____________________________Secretary Signature: _____________________________ Family:_________________ Approval Date: __________

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