Electronic Membership Application Form

Hometown Civitan Club
Electronic Membership Application

Areas of Interest for Hometown Civitan Club Involvement

I hereby request membership in the Hometown Civitan Club. Upon acceptance, I agree to be subject to its by-laws and official policies. I also agree to pay any necessary initiation fees, and regular dues to the club, district and Civitan International, as billed by the club.

By submitting this application electronically, my signature and date of application are confirmed.

Thanks for submitting!