Membership Application

Apply to join the Burley Lions Club and become part of the world's largest service organization.

Personal Information

Member Sponsor Name

First Name *

M.I.

Last Name *

Suffix

Gender

Occupation

Date of Birth

Spouse's Name

Address

Street Address *

City *

State *

ZIP *

Country *

Phone

Email *

Membership Type *

New Member Former Member Transfer Member Family Member Student Member Current or Former Leo Young Adult

Previous Member Number

Previous Club Name

Previous Club Number

Membership Agreement

I accept membership into Lions Clubs International and that the standards are limited to persons of good moral character and reputation. 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.

I agree to the above terms *

Digital Signature

Full Name (typed) *

Date *