General Information

Membership App.
(Please print neatly and legibly in ink.)

Last Name: _____________________________ First Name: _________________________________

Student Number: ____________________ DOB (MM/DD/YYYY): __________________________

Gender: M F Grade: _________ 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 Availability: S M T W Th F S

Course Name Teacher Room #

EB

01

02

03

04

05

06
LB

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.
 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

Dues
• Membership: $15.00 September 16, 2009
• Club t-shirts: $10.00 September 16, 2009
• RTC: $18.00 September 16, 2009
• Fall Rally: $100.00 September 30, 2009
• DCON: TBA 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.

______________________________________ _______________________
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.

___________________________________ ___________________________________
Parent/ Guardian Signature Student Signature

___________________________________
Parent/ Guardian Signature