Membership Application

NOTE:

$10 Application fee to accompany application. Quarterly $25 Pro-Rated Annual Dues

Apr-Jun  $18.75 -  Jul-Sep $12.50 - Oct-Dec $6.25 - due upon acceptance as member

 

Name: L        F        M.I.         Lady:               

Address:                

City:           State:     Zip:           

Phone(s):      

Al Kader Membership No:              

Email Address:              

Business Address:             

Temple Affiliation        Years:       

Shrine or Clown Associations If Any (Example ISCA):           

Member of an Al Kader Unit/Club?     

If Yes, which?          

Clown Name (If Applicable):            

Previous Clown Experience (If Any):   

Reason for Joining Kader Klowns:       

        

         Making this application for membership in Al Kader Shrine’s KADER KLOWNS, I understand if accepted, I will abide by their By-Laws, those of Al Kader Shrine, those of any association the Unit may belong to and Imperial By-Laws.

 

                   

APPLICANT                    DATE

 

                                    

SPONSOR (Not Required)        DATE