The Junior League of Williamsport 2004-05 Provisional Commitment Agreement

Please submit this signed commitment agreement by September 20th. A $30 training fee should accompany this form. Checks should be made payable to The Junior League of Williamsport.

I have read the membership requirements and understand the commitment required.

Signature______________________________________________________

Date_________________________________________________________

Name:
________________________________________________________________
Street Address:
________________________________________________________________
City, State & Zip:
________________________________________________________________
Home Phone:
________________________________________________________________
Work Phone:
________________________________________________________________
E-mail:
________________________________________________________________
Maiden Name (if applicable):
________________________________________________________________
Spouse's Name (if applicable):
________________________________________________________________
Birthdate:
________________________________________________________________

Send To:

Junior League of Williamsport
Atten: Chair of Membership Development Committee
353 Pine Street, Suite 3A
Williamsport, PA 17701