Phenomenal Phoenix Chapter — Membership Interest Form

Phenomenal Phoenix Chapter — Membership Interest Form
Welcome!

Thank you for your interest in the Phenomenal Phoenix Chapter of Jack and Jill of America, Incorporated. Mothers who are interested in Jack and Jill of America, Inc. should visit our national website for more information about our history, goals, programs, and important details regarding membership. Please complete and submit this form to share your interest in Phoenix chapter membership. Additional questions may be sent via email to our Vice President of Membership at jackandjillphxvp@gmail.com.
Name

First NameLast Name
Email
example@example.com
Primary Contact Number
Please enter a valid phone number.
Home City and Zip Code:
Are you Jack and Jill Legacy? (i.e., you were a member as a child and graduated from the organization)
Were you referred by a Jack and Jill mother? If yes, please provide her name.
Why are you interested in Jack and Jill of America, Inc.?
What unique skills or experiences would you like to share that reflect your interests or passions? (i.e., event planning, community service, mentoring, leadership, creative design)
What is your current profession / occupation? (i.e., stay-at-home mom, Attorney at Company X, Business Owner, etc)
List any organizations, community groups or volunteer organizations you belong to, if applicable. (Ex: PTA, Church Ministry, Sorority, Community Organization)
Which grade group(s) will your child(ren) be in the fall of next school year? (please check all that apply)

Pre-KindergartenKindergarten1st grade2nd grade3rd grade4th grade5th grade6th grade7th grade8th grade9th grade10th grade11th gradeGraduating Senior in High School
Should be Empty: