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New Member Application
Title
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Mrs.
Miss.
Ms.
Dr.
Rev.
First Name
Last Name
Birth Date
How long have you lived in the South Bend area?
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Just Moved Here (Less than 1 year)
1-3 years
3-8 years
8+ years
Address
City
State
E-mail
Home Phone
Zip Code
Cell Phone
How did you hear about the Junior League of South Bend?
What do you hope to gain from your JLSB experience?
What part of the Michiana community do you think is in the most need of outreach and support?
What community service activities have you participated in?
What do you want your username to be?
Membership Agreement
Agreement
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