MEMBERSHIP APPLICATIONPlease enable JavaScript in your browser to complete this form. - Step 1 of 3Serving The Roanoke Valley Since 1920IntroductionOur 150 members include city and state government leaders, corporate leaders, nonprofit leaders, church leaders, civic leaders, the 2021 Roanoke City Citizen of the Year, and the 2023 Roanoke City Citizen of the Year. Joining our Club connects you with this large community, positions you to form personal and business relationships, and enables you to join like-minded volunteers passionate about bettering the area in which we live.BackgroundWe are pleased that you see the value in pursuing membership and in serving our community through the many projects we undertake. A Club member will be assigned to assist you during the application period as your Sponsor and to present your application to the Board for consideration. Many children, youth, and seniors are served through these projects, therefore; we are required to do a felony and criminal background and a sex offender check on all potential members (all of the check information is kept confidential). The new member initiation fee of $100 covers the cost for these checks and other local costs, and is required at the time of application. Make checks payable to the Kiwanis Club of Roanoke.DuesUpon approval of your application, you will be billed initially for dues on a prorated basis. Thereafter, you will be billed for dues quarterly in advance. Please indicate your choice of a membership option.Membership Options (pick one): *$280 plus $14 for each of the lunch meals for under age 40 members, for members with 10+ years of service, and for spouses of members. Lunches not charged for Zoom meeting attendance, only in person attendance.$520 plus $14 for each of the lunch meals. Lunches not charged for Zoom meeting attendance, only in person.$900 including all lunch meals.$1,350 corporate membership including all lunch meals.Next StepsOnce your application is approved, you will be introduced to the membership at large at a meeting soon thereafter, you will be asked to attend an orientation session, and you will be given the opportunity to select one or more committees on which you would like to serve. A complete list of committees may be found on our website. The most common path to success for a new member is to get involved quickly. We have many opportunities for involvement that cut across many lines of interest; we have a place for everyone. Your Sponsor will continue to be available to assist you.We meet at 12:30 p.m. – 1:30 p.m. each Wednesday at Charter Hall, on the third floor of the City Market Building in Downtown Roanoke, for lunch, a brief business meeting, and a featured speaker who addresses an issue of current interest; most arrive at 12:00pm for networking. Meetings are available on Zoom. Most of our project work is done in the evenings or on weekends.NextInformation Requested Business Our to Name *FirstLastNicknameDate of Birth (mm/dd/yyyy)Social Security Number (no spaces or hyphens)Cell Phone *Home PhoneEmail *EmailConfirm EmailHome Address *Address Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeBusiness NameBusiness Title or PositionBusiness AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSpouse NameFirstLastHigh School / College AttendedMajor / DegreesPrefer Mail Sent To *BusinessHomePreviousNextHow Long Have You Lived in Our Community?Names of Other Service Clubs Where You Are a MemberNames of Business or Professional Organizations Where You Are a MemberWhat Are Your Reasons for Applying to Our Kiwanis Club? *What Do You Hope To Contribute As a Member? *Have You Been Convicted of a Felony or Sex Related Crime? *NoYesIf yes, explain.Name of Person Who Referred You to Our ClubAny Additional Information You Would Like to Provide? A copy of the submitted application will be emailed to the applicant.Agreement *I agree to the terms below.In submitting this application: I acknowledge that I have attended a meeting of this club as a guest. I have given full disclosure regarding any felony or sex related conviction. I agree to conform to the bylaws and procedures of the club, and I will comply with the civic and financial obligations of membership. I affirm that all information in this application is true and correct. I hereby request the Board of Directors of the Kiwanis Club of Roanoke, VA, to consider my application for membership.Signature * Clear Signature Section DividerPreviousSubmit