Oceanside Pacific Kiwanis - Membership Request

Membership Information Request Form

To receive information from the Oceanside Pacific Kiwanis Club, please complete the following form.

First Name
Middle Initial
Last Name
Address1
Address2
City or Town
State or Province
Zip Code/Postal Zone
E-mail address, if any.
Home Phone
Work Phone
Yes No I am a current Kiwanian who is moving into the Oceanside, California area.
The above address is: Home Business
How did you hear about the Oceanside Pacific Kiwanis Club?
Yes No	Have someone from the membership committee contact me.
Yes No	I would be interested in joining a new club if it is an evening meeting club.