Instructions: Please copy and paste page, fill out application, and fax to 772-563-9472 or email to jlirmembership@gmail.com. Please mail check and completed application to JLIR Headquarters: P.O. Box 274, Vero Beach, FL 32961-0274.
Application for Junior League Membership
I am interested in developing my potential for effective volunteer participation within the community through Junior League membership, and I meet both age and residency requirements.*
Name _____________________________________
Signature _____________________________________ Date_____________
Dues of $125.00 per year and a non-refundable application fee of $25.00 total $150.00. Please make check payable to Junior League of Indian River. Enclosed check # ______________
Personal Information
(This information will be used for our membership directory)
Title for Correspondence (Ms., Miss, Dr., Mrs. etc.) ______________
Name _____________________________________________________________
Last First Middle/Maiden Preferred Name
Address ___________________________________________________________
__________________________________________________________________
E-mail Address__________________________________________
Telephones: Home ___________________Cell_________________
Business _____________________Fax________________
Company Name_________________________________________
Date of Birth ____________________________________________
Spouse or Significant Other’s Name (if applicable) ___________________________
*Age and Residency Requirements : Prospective members shall be no younger than 21 years of age. Prospective members shall live in Indian River County or an adjacent county not designated in another Junior League membership area.
