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I AM MAKING:
TRANSFER REQUEST
AN INTER-LEAGUE REQUEST
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TO THE JUNIOR LEAGUE OF:
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EFFECTIVE DATE OF TRANSFER:
NAME:
MAIDEN NAME:
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DATE OF BIRTH:
SPOUSE'S NAME:
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BEST WAY TO CONTACT YOU:
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CURRENT STATUS:
Provisional
Active
Sustainer
Sustainer Emeritus
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REQUESTED STATUS IN NEW LEAGUE:
Provisional
Active
Sustainer
Sustainer Emeritus
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ORIGINAL MEMBERSHIP IN JUNIOR LEAGUE OF:
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PROVISIONAL YEAR:
MY NEW ADDRESS IN THE NEW LEAGUE CITY IS:
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STREET:
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CITY, STATE:
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ZIP:
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PHONE:
EMAIL ADDRESS:
DATE NEW ADDRESS BECOMES EFFECTIVE:
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