KIWANIS CLUB OF OTTAWA –Membership Application Form

“One Can Make A Difference:

(NOTE: 2sponsors are required, with a combined minimum of three years service in the Club)

We are pleased to recommend the person named below as a prospective member of the Kiwanis Club of Ottawa. We have made them aware of the various commitments and obligations that are listed on the reverse side of this form, and they have expressed a sincere interest in helping to further the Club’s community service objectives.

(PLEASE PRINT)

Full Name of Prospect:______

Preferred First Name:______How Long Have you Known the Prospect?______

Name of Spouse (or equivalent):_______

Company Name:______

Position or Title: ______Type of Business: ______

Business Address:______City/Prov______

Postal Code______Telephone No______Ext.______Fax No______

email address: ______website: ______

Home Address:______City/Prov______

Postal Code______Telephone No.______Fax No.______

Please describe the prospect’s previous Service Club and/or Community Volunteeractivities. In particular, this section should specify the roles the prospect played in these activities, and the length of time they were involved in each volunteer role:

______

Please mention other Business or Professional Organizations in which the prospect was or is involved, and provide details of the type and length of involvement:

______

(continued…)

-2-

Describe any Other Interests, Hobbies, Special Skills and Accomplishments of the prospect which you feel would be of interest to the Membership Committee:

______

- 2

They have participated in our activities (Friday luncheons, social events or fundraisers) on at least 3occasions and has met several members of the Club. We recommend this person for membership in the Kiwanis Club of Ottawa for the following reasons:

______

We have discussed the Club’s structure with the prospect and, based on their interests, we recommend them for the following committee:

__X______

Experience has shown that new members are uncomfortable if they are not made aware

of certain requirements and procedures of the Club. For this reason,

IT IS ESSENTIAL THAT THE SPONSOR DISCUSS THE FOLLOWING TOPICS IN DETAIL WITH A

POTENTIAL MEMBER BEFORE THIS FORM IS SUBMITTED
Discussed?

A/ Attendance - A member is expected to maintain at least 70% attendance.

Explain how attendance credits can be obtained outside of our Friday luncheons. Y/N ( )

In particular, the Leave of Absence for circumstances requiring a temporary absence.

B/ Club Structure and Committees - Our Club’s lifeblood is the committee work. Y/N ( )

A new membermustbecome an active participant on at least one committee.

C/ Financial - After the $250 initiation fee, the total annual cost of membership is Y/N ( )

approximately $1,100, which includes Annual Membership Dues of $355, and bi-weekly

Luncheons of $728 ($28 per week x 26 ) which must be prepaid quarterly, as well as

small incidentalssuch as raffle prizes and refreshments.
D/ Police Record Check–is required for ALL new members (effective January 17, 2008) Y/N ( )

and must be current (within 2 years). Since you are seeking membership to ‘primarily serve the

vulnerable sector of the population’ there should not be any charge.

SPONSORS:

Print Names: Sponsor #1 ______Sponsor #2______

Signature:X_______Signature: X_______

For office use only ( 4-6 weeks procedure)

1. PROPOSAL HANDED IN: Date:______/20______

2. RECOMMENDED TO THE BOARD BY MEMBERSHIP COMMITTEE:______/20______

3. APPROVED BY THE BOARD OF DIRECTORS:______/20______

4. Bulletined in our Club Newsletter for 10 days, to ensure No Objections______/ 20_____

4. SPONSORS ADVISED(when date with no objections has passed):______/20______

5. NEW MEMBER INTRODUCED TO THE CLUB:______/20______

PRIVACY POLICY The Kiwanis Club of Ottawa is committed to protecting and safeguarding the personal information that is given to us. We do not trade our membership lists, but rather use them to keep members informed about Kiwanis Club of Ottawa activities and services. Please contact the office if you want your name removed from our mailing list. Revised: June 2010