NJWC Naperville Juniorettes Membership Application

$25/year dues (Checks payable to NJWC)

Contact Information:

Name: ________________________________________________________________________

Address:_______________________________________________________________________

City, State, Zip Code:  _____________________________________________________________

Cell Phone: ____________________________  Email Address: ____________________________

School Attending: ______________________________________________ Grade: ____________

Date of Birth: ___________________________________________________________________

Previous Volunteer Experience:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Do you have any food allergies or dietary restrictions? If so, please list them: ______________________________________________________________________________

Emergency Contact:

Name:  ________________________________________________________________________

Home Phone/ Work Phone:_________________________________________________________

Cell Phone: ____________________________  Email Address: ____________________________

Agreement and Parent’s Signature:

By submitting this application, I affirm that the facts set forth in it are true and complete. I have read the membership requirements and hereby submit my application for consideration. I understand that photos may be taken and published. My parents approve of my Juniorettes membership and have signed below.

Applicant’s signature:   ____________________________________________________________

Parent's Name (Printed):   __________________________________________________________

Parent’s Signature:      _____________________________________________________________

Date:  _________________________________________________________________________

last updated 2/17/21