Form

New Membership Application

Personal Information

First Name

Last Name

Nickname/Preferred Name

Pronouns

Date of Birth

Contact Information

Street Address

Address Line 2

City

State/Province/Region

Zip/Postal Code

Phone

Email Address

Partner/Spouse Name (If Applicable)

First

Last

Occupation

Current Employer

Occupation

Other Information

Were you referred by a friend or co-worker who is a JLP member? If yes, please list their name.

Please describe any areas of special interest or professional expertise:

Acknowledge and Complete

Review New Member Requirements (will open new tab/window)

JLP New Member Agreement

By checking this box, I confirm that I have read and agree to fulfill the requirements of JLP New Members. Once you submit this application you will be redirected to our New Member dues payment page. New Member dues must be submitted to complete the application process. Please submit your dues by November 5, 2021.

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