I express a preference to serve on the committee, or committees, checked below:


K Attendance K Constitution and By-Laws K Finance K Greeter K Leadership Development
K Lions Information K Membership K Program K Public Relations-Bulletin Editor



K Diabetes Awareness K Sight Conservation and

Work with the Blind K Hearing Conservation and

Work with the Deaf K Environmental Services K International Relations K Leo Club Programs
K Youth Exchange K Youth Outreach

I realize that membership in my Lions club is attained by invitation only. I realize that invitation
standards are high and that invitation is to be limited to persons of good moral character and reputation.

In proposing this candidate for membership, I attest that they are morally, socially and financially
responsible, and that, in my estimation, will become an active member, in support of our objects
and ethics.

I have known the prospective member for ___________________ months/years. If candidate is
approved, I will extend an invitation to join our club, and if accepted, I pledge my personal interest in
this Lion’s development and progress in the principles of Lions Clubs International.

____________________________________ __________________ Signature of Sponsoring Lion Date

____________________________________ __________________ Signature of Secretary Date

Approved By:

____________________________________ __________________ Chairman, Membership Committee Date

____________________________________ __________________ Board of Directors Date

If not approved, other action ______________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________

We are global.


www.lionsclubs.orgLions Clubs International PURPOSES

TO ORGANIZE, charter and supervise service clubs to be known as Lions clubs.

TO COORDINATE the activities and standardize the administration of Lions clubs.

TO CREATE and foster a spirit of understanding among the peoples of the world.

TO PROMOTE the principles of good government and good citizenship.

TO TAKE an active interest in the civic, cultural, social and moral welfare of the community.

TO UNITE the clubs in the bonds of friendship, good fellowship and mutual understanding.

TO PROVIDE a forum for the open discussion of all matters of public interest; provided,
however, that partisan politics and sectarian religion shall not be debated by club members.

TO ENCOURAGE service-minded people to serve their community without personal financial
reward, and to encourage efficiency and promote high ethical standards in commerce, industry,
professions, public works and private endeavors.


TO BE the global leader in community and humanitarian service.


TO EMPOWER volunteers to serve their communities, meet humanitarian needs,
encourage peace and promote international understanding through Lions clubs.


IN THE LIONS CLUB OF: ___________________________________________________________________________________________________ PLEASE PRINT: K MR. K MRS. K MISS K MS. __________________________________________________________________________________________________________________________

First Name MI Last Name

________________________________________________________ Spouse’s Name

________________________________________________________ Spouse’s Occupation

________________________________________________________ Home Address

________________________________________________________ Home City, State/Province, Zip Code

________________________________________________________ Home Country

________________________________________________________ Home Telephone No.

________________________________________________________ Home Fax No.

________________________________________________________ Home E-mail:

Date of Birth:___________________________________ Send Mail: K Home K Business

How long in present occupation?____________ IamaformerLion. KYes KNo

Suffix Nickname

________________________________________________________ Candidate’s Employer

________________________________________________________ Candidate’s Occupation/Title

________________________________________________________ Business Address

________________________________________________________ Business City, State/Province, Zip Code

________________________________________________________ Business Country

________________________________________________________ Business Telephone No.

________________________________________________________ Business Fax No.

________________________________________________________ Business E-mail

________________________________________________________ Cell Phone No.

Reason for Leaving:________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________

I am a member of another service organization. K Yes K No If yes, which ones? ________________________________________________________________________________________________________

Enclosed is $_____________as entrance fee, semi-annual dues, semi-annual international
per capita tax and convention fee. $2.375 U.S. or its equivalent of the above amount is for a six
months subscription to THE LION Magazine.

I accept membership into Lions Clubs International. I recognize the importance of rendering
personal service to my community in cooperation with other civic-minded persons. I appreciate
the opportunity for membership offered to me by Lions Clubs International.

Signature _____________________________________________________________________________ Date____________________________


Lions Clubs International News
Connect with Us Online