Junior Catholic Daughters of the Americas
MEMBERSHIP APPLICATION
Date
*
/
Month
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Day
Year
Date
Birthdate
*
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Month
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Day
Year
Date
School Grade
*
Name
*
Address
*
City
*
State
*
Zip
*
Telephone
*
Format: (000) 000-0000.
Email
*
example@example.com
Parish
*
Senior Court Name
*
No.
*
City of Court
*
PHOTO RELEASE
I give my permission for my daughter to be
photographed or videotaped during JCDA functions.
Signature of Applicant
*
Signature of Parent or Guardian
*
Signature of Parent or Guardian
*
Signature of Court Chairperson
Date
*
/
Month
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Day
Year
Date
~~~~TO BE COMPLETED BY COURT CHAIRPERSON~~~~
Leave Blank
Date Application Received
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Month
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Day
Year
Date
Date of Reception
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Month
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Day
Year
Date
Approved by the National Board 09/18
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