2022-2023 Provisional Membership Application

Membership to JA of Rankin County is a minimum of a six (6) year commitment (1 Provisional Year, and 5 Active Years). As a member of JA of Rankin County, you will also have financial and volunteer obligations to this organization each year.

Provisional Year

Must attend 2/3 of meetings, 6 Administration Hours, 18 Education Hours and 12 Service Hours
Fees for membership, name tag and apron are $75
Must purchase one ticket for themselves and sell a minimum of 3 additional Children’s Benefit Gala tickets

Active Year

Must attend chapter meetings, Spring and Fall Socials, the annual Children’s Benefit Gala, and complete 24 Service Hours, 12 Education Hours and 12 Administration/Finance Hours
Fees for membership each year are $150
Must purchase one ticket for themselves and sell a minimum of 3 additional Children’s Benefit Gala tickets

2022-2023 Provisional Membership Application

Do you foresee any reason you would not be able to fulfill this commitment? If so, please explain.*
Name*
First Middle Last
Birthday*
MM slash DD slash YYYY
How many years have you lived in Rankin County?*

Eligibility - one year minimum
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone - Cellular*
Phone - Work
Email*
Enter Email Confirm Email
Place of Employment
Occupation/Title
Children
1. Name
First Last
Age
School
Grade
2. Name
First Last
Age
School
Grade
3. Name
First Last
Age
School
Grade
4. Name
First Last
Age
School
Grade
Emergency Contact Name*
First Last
Emergency Contact Relationship
Emergency Contact Phone*
List any leadership responsibilities, volunteer work, organizational membership or any other activities which might qualify you as a candidate for membership of JA of Rankin County*
JARC Relevance*
Please explain briefly what would make you a good addition to JARC.
1. Reference Name*
First Last
Reference Email*
Reference Phone*
2. Reference Name*
First Last
Reference Email*
Reference Phone*
JUNIOR AUXILIARY SPONSORSHIP
Do you know a member of JA of Rankin County?*
If Yes, JARC Member Name
Chapter
Level
Sponsor Email
Sponsor Phone
Have you ever applied for membership to JARC?
Consent*
I agree to the privacy policy.
By clicking here, I verify that all of the information I have provided is true and correct. I understand that at any time, Junior Auxiliary of Rankin County can rescind any rights or privileges to an applicant.

2022-2023 Provisional Membership Application

2022-2023 Provisional Membership Application

JUNIOR AUXILIARY SPONSORSHIP