2025 Membership

2025 Membership

Renewals/New Members/Drops
Please use this Jotform to let IL Membership VP know of changes to your Chapter Roster. Payment is not needed with this form.

Either type names into each respective box or upload an excel spreadsheet to the form. Any questions, please reach out to Membership VP Jason, jason.dick@iljaycees.org.
Chapter*
Email*
example@example.com
Number of New Members
More than 5? Submit second form
Renewals
Drops

New Member #1
Name*

First NameLast Name
Date of Birth *

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Gender*
Industry*
Which of the following is the member interested in?*

Individual Growth: personal and professional developmentBusiness and Entrepreneurship: networking and business developmentCommunity Action: advocacy, service, and impactInternational Cooperation: networking and international relationsOther
Who Recruited, Employer Info, etc.

New Member #2
Name*

First NameLast Name
Date of Birth *

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Gender*
Industry*
Which of the following is the member interested in?*

Individual Growth: personal and professional developmentBusiness and Entrepreneurship: networking and business developmentCommunity Action: advocacy, service, and impactInternational Cooperation: networking and international relationsOther
Who Recruited, Employer Info, etc.

New Member #3
Name*

First NameLast Name
Date of Birth *

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Gender*
Industry*
Which of the following is the member interested in?*

Individual Growth: personal and professional developmentBusiness and Entrepreneurship: networking and business developmentCommunity Action: advocacy, service, and impactInternational Cooperation: networking and international relationsOther
Who Recruited, Employer Info, etc.

New Member #4
Name*

First NameLast Name
Date of Birth *

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Gender*
Industry*
Which of the following is the member interested in?*

Individual Growth: personal and professional developmentBusiness and Entrepreneurship: networking and business developmentCommunity Action: advocacy, service, and impactInternational Cooperation: networking and international relationsOther
Who Recruited, Employer Info, etc.

New Member #5
Name*

First NameLast Name
Date of Birth *

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Gender*
Industry*
Which of the following is the member interested in?*

Individual Growth: personal and professional developmentBusiness and Entrepreneurship: networking and business developmentCommunity Action: advocacy, service, and impactInternational Cooperation: networking and international relationsOther
Who Recruited, Employer Info, etc.

Please use this Jotform to let IL Membership VP know of changes to your Chapter Roster. Payment is not needed with this form.