JLR Reinstatement Form

JLR Reinstatement Form

Welcome back to the Junior League of Raleigh! Please take a moment to fill out the information below so we can update your membership profile in the database and process your Reinstatement request.

Name:

Street Address:

City, State:

Zip Code:

Mobile Phone:

Home Phone (if applicable):

Email Address:

Emergency Contact Name/Relationship:

Emergency Contact Email:

Emergency Contact Phone:

Please tell us why you resigned from the league?:

Status when you resigned from the league: Select ... Active Non-Resident Active Non-Resident Sustainer Sustainer

Please tell us why you are reinstating at this time:

Were you a member of any other league(s)?: Select ... Yes No

If you answered yes, please list the league(s):

Are you employed outside of the home?: Select ... Yes No

If you answered yes, please list your employer and your position below.

We look forward to your reinstatement with the league, thank you for submitting this information!

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