Membership App

Membership App.

General Information

(Please print neatly and legibly in ink.) Last Name: _____________________________ First Name: _________________________________ Student Number: ____________________ Gender:

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F

Grade: _________

DOB (MM/DD/YYYY): __________________________ Class of: ____________

Drive:

Yes

No

Address: _______________________________________________________________________________ Home Phone: __________________________

Cell Phone: _______________________________

E-mail: _______________________________________

AIM/Yahoo! SN: ______________________

Other Contact: _________________________________________________________________________ Hobbies/Interests: ______________________________________________________________________ Other School Activities: _________________________________________________________________ Zoned High School: ____________________________________________________________________ Random Fact About Yourself: ___________________________________________________________ T-Shirt Size:

S

M

L

XL

Course Name EB 01 02 03 04 05 06 LB

Availability: S

M T

W Th F

Teacher

S Room #

About Key Club This page should have all the information you need to know about Key Club, in general. If, by chance, your question is not answered with this excerpt, feel free to ask the club officers or advisor. What is Key Club? We do not, in fact, manufacture and/or decorate keys. KEY stands for Kiwanis Educating Youth. Key Club International is the oldest and largest service program for high school students. It is a student-led organization that teaches leadership through serving others. Members of Key Club, a part of the Kiwanis International Family, build themselves as they build their schools and communities. First created in Sacramento High School in California, on May 7, 1925, Key Club now exists on nearly 5,000 high school campuses worldwide to date. Key Club Pledge We recite this pledge at the beginning of every meeting, so it would be best to know it. I pledge on my honor, to uphold the objects of Key Club International; to build my home, school, and community; to serve my nation and God; and to combat all forces, which tend to undermine these institutions. Key Club Motto “Caring – Our way of life.” Vision Statement To develop competent, capable, and caring leaders through the vehicle of service Mission Statement Key Club is an international, student-led organization providing its members with opportunities to perform service, build character, and develop leadership.

Core Values Key Club International, through its strategic planning process, is clarified and committed to four organizational core values-guiding principles which are central to our international organization: Caring, Character Building, Inclusiveness, Leadership Objects of Key Club International • To develop initiative and leadership • To provide experience in living and working together. • To prepare for useful citizenship • To cooperate with the school principal • To accept and promote the following ideals: o To give primacy to the human and spiritual rather than to the material values of life o To encourage the daily living of the Golden Rule in all human relationships o To promote the adoption and application of higher standards in scholarship, sportsmanship, and social contacts o To develop, by precept and example, a more intelligent, aggressive, and serviceable citizenship. o To provide a practical means to form enduring friendships, to render unselfish service, and to build better communities. o To cooperate in creating and maintaining that sound public opinion and high idealism, which will make possible the increase of righteousness, justice, patriotism, and goodwill. Valley Key Club Visit our website online at www.vhskeyclub.com for information, media, news, and anything else you would like to know about our school club.

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Membership Requirements Members MUST turn in completed application and pay dues by October 21st Members must complete 20 hours of community service per semester Members must participate in 5 hours of community service per month Members must attend 2 general meetings per month o Wednesdays, 2:15 in room 254 Members must attend the member induction ceremony Members must be a Valley High School student working toward graduation requirements Fall Rally Requirements Must meet ALL membership requirements Must attend the Regional Training Conference Must attend all scheduled Valley spirit preps Must attend at least 2 Divisional Council Meetings Must have Fall Rally paid by deadline set by Club Treasurer Must have approval of Club Advisor and Lt. Governor District Convention Requirements Must meet all membership requirements Must attend all spirit preps Must have paid registration fee by deadline set by Club Treasurer o Must have participated in club fundraisers Must have shown some interest in the club and gained approval from Club Advisor, School Administration, and Key Club board

Membership: Club t-shirts: RTC: Fall Rally: DCON:

Dues $15.00 $10.00 $18.00 $100.00 TBA

September 16, 2009 September 16, 2009 September 16, 2009 September 30, 2009 TBA

I, _______________________________________, have read and understood the above listed requirements for obtaining and maintaining Key Club Membership, attending Fall Rally, and attending the California-Nevada-Hawaii Key Club District Convention. ______________________________________

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Applicant Signature

Date

Parent/Guardian Consent Parent/Guardian Contact Information: Name: __________________________________________________________________________ Email: __________________________________________________________________________ Cell Phone: _____________________________________________________________________ Work Phone: ____________________________________________________________________ Home Phone: ___________________________________________________________________ Name: __________________________________________________________________________ Email: __________________________________________________________________________ Cell Phone: _____________________________________________________________________ Work Phone: ____________________________________________________________________ Home Phone: ___________________________________________________________________ I give permission for my son/daughter to participate in the various community services and volunteer activities sponsored by Valley High School Key Club.

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Parent/ Guardian Signature

Student Signature

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Parent/ Guardian Signature