INVITATION FOR MEMBERSHIP

o Mr. o Ms._____________________________________________________________________________

First Name (Please Print)MILast Name

Home Address__________________________________________________ Home phone #_______________

Date of Birth_____/_____/_____Spouse’s Name_____________________________

Work AddressEmployer Name____________________________ & Address________________________________________

Title/Position_____________________Business Phone______________________________________

Business Fax# _________________ email address___________________Business Website Address____________________

Are you a former member of Lions Club?oYesoNo

List service organizations to which you belong:_______________________________________________

If accepted as a member, you will be expected to become active on one or more committees of the Duncanville Lions Club.Please check your preference of committee work below:

o July 4^th Eventso Membership/Retentiono Weekly Programs

oLas Vegas Scholarship Auctiono Scholarship Selectiono Lions Club Community Bldg.

oIndependentLivingCentero Golf Tournamento Literacy Fair

o Low Vision Clinico Telephoneo Pancake Breakfast

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 Club International, I hereby accept membership.

____________________________________ __________________________________

Prospective New MemberDate

SUBMIT $65.00 WITH APPLICATION ($25.00 initiation fee and $40.00 for first month's dues; dues are $40.00 per month thereafter)

After 1st month indicate address where you wish to be billed ______ home or ______ work

Sponsor-If this candidate is approved, I will pledge my personal interest in this Lion’s development and progress in the principles and the work of Lionism.

Signature of Sponsoring Lion___JOE KYLE_______________________ DATE________Attest by Club Secretary_______________________________