Kiwanis Club of East Hampton Information Request Form

KIWANIS CLUB OF EAST HAMPTON
MEMBERSHIP INFORMATION
REQUEST FORM

Please complete the following form if you would like to receive membership information about our Kiwanis Club and/or Kiwanis International. At the end of the form, please indicate how you would like us to send you the information (E-mail, snail-mail, or by telephone). You may also correspond or request information by regular mail addressed to Kiwanis Club of East Hampton, Post Office Box 1902, East Hampton, New York 11937.


First Name:     
Middle Name:    
Last Name:      
Home address:   
                
City:           
State:  Zip:   Country: 
E-mail Address: 
Daytime Phone:  
Evening Phone:  
Fax:            
How did you hear about us? 

Which best describes your current situation? 

Are you interested in joining Kiwanis?......   Yes   No 
Are you in any other community service clubs?  Yes   No 
If Yes, indicate club name 




How would you like us to provide you with information?
E-mail...................... 
Snail-Mail (Surface Mail)... 
Voice Telephone............. 
Fax......................... 




Feel free to use the area below for any questions or comments
you might have concerning The Kiwanis Club or our website.

Club Background • Officers & Members • Activities & Events • Club News • Guest Book

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