2019-2020 Provisional Class Application

*Recruitment Session

First Name

Last Name

*Address Street 1

Address Street 2

*City

*State

*Zip

Neighborhood

Day Phone

*Evening Phone

*Email

*Birthdate

*Age

*Occupation

*Highest Level of Education

Relationship Status

Children

Hobbies:

Relevant Volunteer and Leadership Experience:

I enjoy living in the Portland metropolitan and surrounding areas because:

Places you have also lived (if applicable):

If invited to join the Provisional Class of the Junior League of Portland, I would seek more:

If invited to join the Provisional Class, I will expect to gain:

If invited to join the Provisional Class, I expect to contribute:

*I heard about the Junior League of Portland from:

Please list the specific Junior League of Portland member (if applicable):

Please list the other Junior League or other referral source (if applicable):

I am applying for the Provisional Class with the following women (if applicable):

Digital Signature

*Date

Please upload a photo of yourself

*Required Email

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