{"id":410,"date":"2025-03-08T19:45:40","date_gmt":"2025-03-08T19:45:40","guid":{"rendered":"https:\/\/chestertownlions.org\/?page_id=410"},"modified":"2025-03-13T18:03:30","modified_gmt":"2025-03-13T18:03:30","slug":"membership-application","status":"publish","type":"page","link":"https:\/\/chestertownlions.org\/index.php\/membership-application\/","title":{"rendered":"Chestertown Lions Membership Application"},"content":{"rendered":"\n<p class=\"has-text-align-left\">Printable\/Downloadable version also below<\/p>\n\n\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f444-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"444\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/410#wpcf7-f444-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"444\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f444-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<form>\n\t<p><label>Name:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span><br \/>\n<label>Mailing Address:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-address\" \/><\/span><br \/>\n<label>Date of Birth:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-dob\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"your-dob\" \/><\/span><br \/>\n<label>Email:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span><br \/>\n<label>*Home Phone:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-home-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"your-home-phone\" \/><\/span><br \/>\n<label>Work Phone:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-work-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"your-work-phone\" \/><\/span><br \/>\n<label>*Cell Phone:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-cell-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"your-cell-phone\" \/><\/span><br \/>\n<label>Occupation:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-occupation\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-occupation\" \/><\/span><br \/>\n<label>Name of Spouse \/ Partner:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-spouse\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-spouse\" \/><\/span><br \/>\n<label>*Sponsor:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-sponsor\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-sponsor\" \/><\/span><br \/>\n<label>Date of Application:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"2026-04-12\" type=\"date\" name=\"your-date\" \/><\/span><br \/>\n<label>Programs\/Activities of Interest:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"activities\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"activities[]\" value=\"Bay to Bay Bike Ride\" \/><span class=\"wpcf7-list-item-label\">Bay to Bay Bike Ride<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Chicken BBQ\" \/><span class=\"wpcf7-list-item-label\">Chicken BBQ<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Adopt a Highway\" \/><span class=\"wpcf7-list-item-label\">Adopt a Highway<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Christmas Basket Program\" \/><span class=\"wpcf7-list-item-label\">Christmas Basket Program<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Shotgun Raffle Sales\" \/><span class=\"wpcf7-list-item-label\">Shotgun Raffle Sales<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Peace Poster Contest\" \/><span class=\"wpcf7-list-item-label\">Peace Poster Contest<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Vision Screening for Kids\" \/><span class=\"wpcf7-list-item-label\">Vision Screening for Kids<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Transportation Program (eye appointments)\" \/><span class=\"wpcf7-list-item-label\">Transportation Program (eye appointments)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Christmas Flowers \/ Gifts for Nursing Homes\" \/><span class=\"wpcf7-list-item-label\">Christmas Flowers \/ Gifts for Nursing Homes<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Homeports Health Fair\" \/><span class=\"wpcf7-list-item-label\">Homeports Health Fair<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Food Pantry\" \/><span class=\"wpcf7-list-item-label\">Food Pantry<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Lions helping with 4H Fair\" \/><span class=\"wpcf7-list-item-label\">Lions helping with 4H Fair<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Halloween Parade\" \/><span class=\"wpcf7-list-item-label\">Halloween Parade<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"activities[]\" value=\"Diabetes Awareness\" \/><span class=\"wpcf7-list-item-label\">Diabetes Awareness<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"activities[]\" value=\"Other\" \/><span class=\"wpcf7-list-item-label\">Other<\/span><\/span><\/span><\/span><br \/>\n<label>If Other, Please Specify:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-other-interest\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-other-interest\" \/><\/span><br \/>\n<label>Additional Comments:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span><br \/>\n<label>Membership dues will be billed quarterly. The cost is $31.00 per quarter plus the cost of meals for the dinner meetings you attend. For regular dinner meetings the cost is $22.00 per meal. For special dinners (Christmas and Valentines) the price will be slightly higher. You will be receiving an email from the Lions Club Secretary a week before each meeting to RSVP. We have to take reservations so the Country Club has an accurate count for meals.<br \/>\nWelcome ! Great to have you as a member of our club!<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap kc_captcha cf7ic-toggle\" data-name=\"kc_captcha\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"captcha-image\" style=\"display: none;\"><span class=\"cf7ic_instructions\">Please prove you are human by selecting the<span> cup<\/span>.<\/span><label><input aria-label=\"1\" type=\"radio\" name=\"kc_captcha\" value=\"bot\" \/><svg aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 576 512\"><path fill=\"currentColor\" d=\"M488 313v143c0 13-11 24-24 24H348c-7 0-12-5-12-12V356c0-7-5-12-12-12h-72c-7 0-12 5-12 12v112c0 7-5 12-12 12H112c-13 0-24-11-24-24V313c0-4 2-7 4-10l188-154c5-4 11-4 16 0l188 154c2 3 4 6 4 10zm84-61l-84-69V44c0-6-5-12-12-12h-56c-7 0-12 6-12 12v73l-89-74a48 48 0 00-61 0L4 252c-5 4-5 12-1 17l25 31c5 5 12 5 17 1l235-193c5-4 11-4 16 0l235 193c5 5 13 4 17-1l25-31c4-6 4-13-1-17z\"\/><\/svg><\/label><label><input aria-label=\"2\" type=\"radio\" name=\"kc_captcha\" value=\"kc_human\" \/><svg aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 640 512\"><path fill=\"currentColor\" d=\"M192 384h192c53 0 96-43 96-96h32a128 128 0 000-256H120c-13 0-24 11-24 24v232c0 53 43 96 96 96zM512 96a64 64 0 010 128h-32V96h32zm48 384H48c-47 0-61-64-36-64h584c25 0 11 64-36 64z\"\/><\/svg><\/label><label><input aria-label=\"3\" type=\"radio\" name=\"kc_captcha\" value=\"bot\" \/><svg aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 640 512\"><path fill=\"currentColor\" d=\"M624 352h-16V244c0-13-5-25-14-34L494 110c-9-9-21-14-34-14h-44V48c0-26-21-48-48-48H48C22 0 0 22 0 48v320c0 27 22 48 48 48h16a96 96 0 00192 0h128a96 96 0 00192 0h48c9 0 16-7 16-16v-32c0-9-7-16-16-16zM160 464a48 48 0 110-96 48 48 0 010 96zm320 0a48 48 0 110-96 48 48 0 010 96zm80-208H416V144h44l100 100v12z\"\/><\/svg><\/label>\r\n    <\/span>\r\n    <span style=\"display:none\">\r\n        <input type=\"text\" name=\"kc_honeypot\">\r\n    <\/span><\/span><\/span>\n\t<\/p>\n\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit Application\" \/>\n\t<\/p>\n<\/form><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"219\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\n\n\n<div class=\"wp-block-file\"><object class=\"wp-block-file__embed\" data=\"https:\/\/chestertownlions.org\/wp-content\/uploads\/2025\/03\/New-Member-Application-Mar-8-2025-1.pdf\" type=\"application\/pdf\" style=\"width:100%;height:800px\" aria-label=\"New Member Application Mar 8 2025\"><\/object><a id=\"wp-block-file--media-74209f27-41b9-4e65-81da-8a6f399e8008\" href=\"https:\/\/chestertownlions.org\/wp-content\/uploads\/2025\/03\/New-Member-Application-Mar-8-2025-1.pdf\">New Member Application Mar 8 2025<\/a><a href=\"https:\/\/chestertownlions.org\/wp-content\/uploads\/2025\/03\/New-Member-Application-Mar-8-2025-1.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-74209f27-41b9-4e65-81da-8a6f399e8008\">Download<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Printable\/Downloadable version also below New Member Application Mar 8 2025Download<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-410","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/chestertownlions.org\/index.php\/wp-json\/wp\/v2\/pages\/410","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/chestertownlions.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/chestertownlions.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/chestertownlions.org\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/chestertownlions.org\/index.php\/wp-json\/wp\/v2\/comments?post=410"}],"version-history":[{"count":13,"href":"https:\/\/chestertownlions.org\/index.php\/wp-json\/wp\/v2\/pages\/410\/revisions"}],"predecessor-version":[{"id":450,"href":"https:\/\/chestertownlions.org\/index.php\/wp-json\/wp\/v2\/pages\/410\/revisions\/450"}],"wp:attachment":[{"href":"https:\/\/chestertownlions.org\/index.php\/wp-json\/wp\/v2\/media?parent=410"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}