Form

JLL Membership Application

BIOGRAPHICAL INFORMATION

Last Name

First Name

M.I.

Date

Street Address

Apartment/Unit

City

State

ZIP

Cell Phone

Evening Phone

Birthdate

E-mail Address

Louisville Native

from

Number of Children and Ages

Ethnicity

Please Choose Desired New Member (Provisional) Class

*Please Visit our Website for a list of Community Projects and Involvement*

www.juniorleaguelouisville.org

EDUCATION (FOR INFORMATIONAL PURPOSES ONLY, NOT A REQUIREMENT OF MEMBERSHIP)

High School

City

State

Year of Graduation

College

City

State

Year of Graduation

Major

Minor

Degree

Graduate

City

Year of Graduation

State

Major

Minor

Degree

CIVIC INVOLVEMENT (FOR INFORMATIONAL PURPOSES ONLY, NOT A REQUIREMENT OF MEMBERSHIP)

Please list any organizations, including professional, in which you are currently a member

EMPLOYMENT (FOR INFORMATIONAL PURPOSES ONLY, NOT A REQUIREMENT OF MEMBERSHIP)

Company

Phone

Address

Position

Classification

The Junior League of Louisville tries to support businesses owned by our members whenever possible.
If you are a business owner, please list the name of the company and the type of services provided so that we can show our support, if possible!

Personal Business / Services Provided

Please tell us how you heard about Membership in the Junior League

DISCLAIMER AND SIGNATURE

I have reviewed the enclosed information regarding membership in the Junior League of Louisville and I understand the responsibilities and obligations of Provisional Member

Check to Sign Agreement

Date

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