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INVITATION-APPLICATION FOR MEMBERSHIP
IN THE LIONS CLUB
OF
PLEASE PRINT
o Mr.
0 Mrs.
a Miss 0 Ms. _____.._____________________________________________________________________________________
First Name
MI
Last Name
Suffix
Nickname
Spouse's Name
Candidate's Employer
Spouse's Occupation
Candidate's Occupation Title
Home Address
Business Address
Home City, ST/Province, Zip Code
Business City, ST Province, Zip Code
Home Country
(->
Home Telephone No.
Business Country
<
>
Business Telephone No.
o Business
(-)
Business Fax No.
Date of Birth: ___
Send Mail: 0 Home
Candidate a Former Member?
0 Yes
0 No
Reason for Leaving:
How long in present Occupation?
Other Service Organizations Candidate a Member of:
Enclosed is $
as entrance fee, semi-annual dues, semi-annual international
per capita tax,
and convention fee. $2.375 U.S. or its equivalent
of the above amount
is for a six months subscription to
"THE LION" magazine.
Recognizing the importance of rendering personal
service to my community in cooperation with other
civic-minded persons, and appreciating the opportunity afforded me
to enjoy the good fellowship and
prestige of Lions Clubs International, I hereby accept membership.
Signature
Date
I express a preference to serve on the committee, or committees,
checked below:
ADMINISTRATIVE COMMITTEES
o Attendance
o Constitution and By-Laws
o Convention
o Finance
o Greeter
o Leadership Development
o Lions Information
o Membership
ACTIVITIES COMMITTEES
o Diabetes Awareness
o Sight Conservation and Work with the Blind
o Hearing Conservation and Work with the Deaf
o Environmental Services
o International Relations
o Leo Club Program
o Lioness Club Program
o Youth Exchange
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