Springfield Jaycees Membership Application
Welcome to the Springfield Jaycees! In our organization, we believe that "Service to humanity is the best work of life!" If you love the Springfield community and you would like to help make a difference in our community, we would love to have you join our organization.
First and Last Name: *
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Email *
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Primary Phone Number: *
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Date of Birth: *
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Street Address: *
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City, State, Zip Code: *
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Referred by: *
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Please list ways you hope to contribute to the chapter along with your areas of interest: *
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Membership Agreement: I understand that as a member of the Springfield Jaycees, I will commit to volunteer at 3 events per calendar year and pay a $68.00 annual membership fee. *
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I understand that the Springfield Jaycees reserves the right to approve or decline membership applications. I hereby give the Springfield Jaycees permission to share my information with the IL Jaycees, JCI USA, and JCI International.
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Please type today's date below. *
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