Director Application

Are you interested in becoming an NLJC Director? Complete the form below. If your background is a good fit and a territory is available, we will contact you within 15 business days.

First Name *

Last Name *

Date of birth *

Email *

Phone *

Address *

Street Address

City

State

Country

Postal code

County *

How long have you been in the area? *

Marital Status *

Spouse's Name

Do you have any children? *

If yes, what age/s?

Currently employed? *

If yes, give name

Facebook Handle *

This helps us get to know more about you

Instagram Handle *

This helps us get to know more about you

What is your educational background? *

How did you hear about NLJC? *

Please describe any experience you have working with students, families, schools, or community organizations, as well as any existing local connections that could support chapter growth. *

Please share a brief summary of your professional background. *

Why are you interested on becoming a director? *

What is the best time to contact you? *