Membership

Name (inc 2nd) *

First

Last

Lion Sponsors name (If NO, we will allocated a member *

I wish to apply to be *

A Full Active Lion Member An Affiliate Lion Member An Internet Lion Member Family Member (Other relative must lodge seperate appl. and reside at same address)

Gender *

Male Female

Date of Birth (dd/mm/yyyy) *

Occupation *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone No. (Land Line) *

Mobile No. *

Email *

How did you find our club? *

Add additional service activity you would like to be involved with *

By adding my name in the box below, I accept membership into The Lions Club of Blockhouse Bay-Lynfield in District 202K of Lions Clubs International and that the membership is limited to persons of good moral character and reputation. I will abide by the ethics and aims of Lions Clubs International (LCI) and agree to the Constitution of this club which is in main part the Standard Constitution of LCI with some amendments to suit local conditions. I recognize the importance of rendering personal service to my community in cooperation with other civic-minded persons. I understand that membership is not valid until approved by the club’s board of directors and my new Lions Application Fee and Membership Dues have been paid when I am Invoiced. I HEREBY AGREE-SIGNED:- *

YOUR CART

Membership Application for Blockhouse Bay-Lynfield Lions Club
if required field* is non applicable enter "Nil".

YOUR CART

Membership Application for Blockhouse Bay-Lynfield Lions Clubif required field* is non applicable enter "Nil".

Membership Application for Blockhouse Bay-Lynfield Lions Club
if required field* is non applicable enter "Nil".