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1 New Member Application form for Kiwanis Club of Anacortes, Inc. K01508 Full Name Nickname Gender Home address: City: State: Zip: Phone, Home: Mobile: Spouse/Partner name: Company name: Title: Business address: City: State: Zip: Business phone: Preferred for Kiwanis contact: If you are a former Kiwanian: Club name: Date left Are you transferring your membership? Yes No Life Member number: Date of Birth Wedding anniversary I am submitting this application for membership and agree to conform to the bylaws of the Kiwanis Club of Anacortes, Inc. as explained to me by my sponsor. Date: Applicant signature: Please Check One Block per Category Primary Employment Job Classification Education Attained 1 Banking/Finance 17 Medical N Elected A Grade School 3 Communion/Media 19 Nonprofit O Management B High School 5 Construction 21 Real Estate P Partner/Owner C VoTech School 7 Education 23 Religion Q Professional D Assoc degree (2 yr) 9 Government 25 Retail R Sales E Bachelors (4 yr) 11 Legal 27 Transportation S Supervision F Masters 13 Manufact.(Heavy) 29 Wholesale T Technical G Grad Prof Degree 15 Manufact.(Light) 94 Other V Retired X Other Page 1 of 8 Date: 19 December 2017

2 New member sponsor To the Board of Directors of the Kiwanis Club of Anacortes, Inc. I take pride in proposing as an active member of our club and have confidence that this individual will become a valuable member. I will help learn how our club functions, learn about Kiwanis and meet other members. Sponsor name: Date: Sponsor name: Date: \ For Kiwanis Club of Anacortes use only Recommendation by the Membership Committee The committee voted to this application. Date: Chairperson signature: Board of Directors action the Board voted to the Membership Committee recommendation. Date: Secretary signature: Date: Membership Number: Induction Date: Receipt Date: Received of: $ Cash/Check For: Received by: Page 2 of 8 Date: 19 December 2017

3 New Member Paperwork and Fees Applicant: Sponsors (2): Date: The following items are needed filled in, signed and dated to complete the membership process: Kiwanis Membership Application (Page1 & 2) New Member Paperwork and Fees (Page 3) Member Commitment Form (Page 4) Background Check (Page 5) Biographical Data (page 6) Note: the New Member Orientation is yours to keep (Page 7 & 8). After your application is processed and approved by the Club's Board of Directors, you will need to submit a check, payable to the Kiwanis Club of Anacortes, for the one-time initiation fee plus the Kiwanis annual dues. Fee Summary There is a onetime initiation fee of $95.00 an additional family member is $55 which includes a charge $15.00 for Club Membership supplies. Annual dues: $77.00 for Kiwanis International, KI $46.00 for Pacific Northwest District, PNW $66.00 for a second family member goes to KI and PNW Our members pay for KI and PNW dues at $ and $66.00 for a second family member. Dues are payable in September. New member's dues are pro-rated for the fiscal year October 1 to September 30. You will be advised of the Dues amount due prior to your installation. Please return the enclosed items (items 1 through 5 as listed above) to either your Sponsor or drop them off at the Kiwanis Thrift Shop. Once we have approvals in hand we will schedule your induction into the Kiwanis Noon Club of Anacortes. After your induction you will be on the Committee of Ten learning about our Club. You will be contacted by a member to schedule a Shop Orientation, The Shop Scheduler will contact you to set up your monthly shop shift. Your Sponsors will help you with this. Welcome to Kiwanis Club of Anacortes. Rick Johnson, Membership Committee Chairperson, Page 3 of 8 Date: 19 December 2017

4 Member Commitment As a member of Kiwanis Club of Anacortes, Inc., I will endeavor to abide by and accept the responsibilities pertaining to my membership. I understand and accept the objectives of Kiwanis International: 1. To give primacy to the human and spiritual rather than to the material values of life. 2. To encourage the daily living of the Golden Rule in all human relationships. 3. To promote the adoption and the application of higher social, business, and professional standards. 4. To develop, by precept and example, a more intelligent, aggressive, and serviceable citizenship. 5. To provide, through Kiwanis clubs, a practical means to form enduring friendships, to render altruistic service, and to build better communities. 6. To cooperate in creating and maintaining that sound public opinion and high idealism which make possible the increase of righteousness, justice, patriotism, and goodwill. As a new member, you'll become a member of the Committee of Ten, made up of the ten newest members of the Club. There you'll learn more about Kiwanis and the workings of our Club. Committee of Ten meetings are hosted by the Immediate Past President and held monthly. You will "graduate" as the Club continues to add new members. You are encouraged to attend other committee meetings while on the Committee of Ten in order to explore the committees and see which committee fits your interests. Attending our Club Thursday meeting provides you the opportunity to socialize and learn of the Club's ongoing activities. Members are encouraged to attend when possible. We don't track attendance and there are no "fines" for missing meetings. Note: If you expect to miss meetings or shop shifts for at least 30 days or up to 6 months due to travel, vacation, illness or business, you should request a Leave of Absence. Forms are available in the Shop Office and should be submitted to either the Club Secretary or the Membership Chair before a Board meeting usually the 3 rd Friday of the month. You must find a shop replacement (or swap) if you must miss your assigned shop duty. I will do the following: 1. Participate in the Committee of Ten meetings and projects, learning about Kiwanis and finding a place where I can contribute to the work of the Club. 2. Work at least one 4 hour Shop Shift each month (The Shop Scheduler will help with this) 3. Join one of the Club's service committees and help our Club support our community. Signature: Date: Page 4 of 8 Date: 19 December 2017

5 Background Check During our service to the community, Kiwanians often interact with; children less than sixteen years of age; developmentally disabled persons or vulnerable adults. Accordingly, in compliance with the Revised Code of Washington (RCW ) and Kiwanis International policies all applicants are subject to a background check. Please complete the following disclosure. Sign and return this page with your application. Disclosure Have you ever: 1. Been convicted of a crime? Yes, No 2. Had finding made against you in any civil adjudicative proceeding? Yes, No 3. Had both a conviction and findings made against you? Yes, No I understand that background checks are necessary before becoming a member of the Kiwanis Club of Anacortes. Inc. I give my permission for the Membership Chairperson to make such checks based on the data in this application and I understand that results are to be held in confidence. Signature: Date: Print full name: Be sure to fill out back of this page. Page 5 of 8 Date: 19 December 2017

6 Biographical Data Places you have lived before moving to Anacortes: Children, grandchildren, Family and Pets? What was your vocation? What are your interests? Hobbies? Skills? Talents? What else would you like Club members to know about you. Page 6 of 8 Date: 19 December 2017

7 New Member Orientation Kiwanis Club of Anacortes, Inc. Our Motto: We serve the children of the world one child one community at a time Time & Place: We meet every Thursday at the Masonic Temple at the comer of 8 tll Street and "0" Avenue. Lunch and Fellowship starts at 11:30 AM; the meeting is called to order at 12:00 noon and adjourns around 1:00. Meeting Badges: Every member is provided with a name tag badge that is to be worn at every meeting. You will also receive a Kiwanis "K" pin which should be worn to every meeting as well. A box of badges is kept at the Masonic Hall; you may place yours there or keep it with you. New Member Aprons: At your induction you will receive a Kiwanis "work apron" and we ask you to wear it for 5 meetings. Members will introduce themselves and sign your apron. After 5 weeks return your apron to the Membership chair; the signatures will be counted. After that, those who failed to sign will come and greet you, sign your apron and donate $1 to the club. Lunch Payment: Our lunches are catered by Gere-a-Deli. The cost is $11 for a full lunch and beverage. If you do not want a full lunch the cost is $4 for beverage and dessert. When you bring a guest, it is traditional for the hosting member to pay for the guest's lunch the first time they visit. The club pays for your lunch on the day you are inducted into membership. Typical Meeting Agenda: President calls meeting to order. Pledge of Allegiance Invocation or Inspirational Thought Introduction of guests and visiting Club members/officers. President asks for announcements Song of the Day Vice President asks for Happy Dollars to share. This includes a dollar for having your name or picture in the newspaper, a birthday or anniversary. Political discussions are inappropriate. Program: Guest speakers present topics of interest. Board of Directors: Meets the 3 rd Friday of the month at noon, usually at the Village Pizza meeting room. Members are encouraged to attend. Page 7 of 8 Date: 19 December 2017

8 New Member Orientation (concluded) Kiwanis Family Clubs in Anacortes Key Club: High School, meets every Wednesday at 2:15 PM at the high school cafeteria. K-Kids: Fidalgo Elementary school meets 1 st Thursday at 2:50PM. Builders' Club: Middle School meets Tuesday A lunch 11 AM, B lunch 11:45 AM, Wednesdays 8:00 AM Aktion Club: meets on the 2 nd and 4 th Thursdays of each month at 5:30 PM at the Anacortes Christian Church, 1211 M. Avenue Committee of Ten: All new members become members of the Committee of Ten (usually meets on the 1 st Monday of each month) which will introduce you to Kiwanis and assist you in discovering what you would like to do in our club. Your membership on this committee ends when ten new members join after you. This committee is responsible for planning and putting on the Club Picnic in August. The Chairperson of the Committee of Ten is the immediate past president. It's a great way to learn about the our Club. Club Committees: Please check out our website, anacorteskiwanis.org for the time and place the committees meet each month. You will learn about the various committees during your time on the Committee of Ten. All members are encouraged to participate in the work of a committee. The Shop: (The Shop at 420 O avenue, Anacortes, WA) is the Kiwanis Club of Anacortes only means of raising money to support community and childrens projects. You will be contacted to schedule a shop orientation so you can see which tasks fit your talents and abilities. You will also be contacted by the Shop Scheduler to pick out your monthly shift time. We encourage you to become as involved in our Shop as you can as there is lots to do. As you get familiar with the Shop you might pick up a 2 nd shop shift, truck driving, help with the pricing team or find a task that fits your interests. Kiwanis Projects: These consist of community projects that you may choose to participate in. These include work parties at the Kiwanis Parks in Anacortes (Waterfront Park, Kiwanis Meadows, Little Cranberry Lake Trail, Washington Park), decorating a float and participating in the Anacortes Christmas and July 4th Parades, going on inter-clubs, helping with Kids-R- Best Fest, helping with club sponsored events such as preschool safety program, bell ringing, the annual Christmas tree pickup and others as announced. Enjoy your service! Page 8 of 8 Date: 19 December 2017

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