Form

Reinstate Your Membership

If you are interested in reinstating your JLN membership, please fill out the short form below and we will be in touch with you to complete your reinstatement.

Reinstatement Requirements

Active Status: Completed provisional year.
Sustainer Status: After completing 8+ years of active service.
Sustainer Emeritus: Granted to members age 80+
Must pay current dues and $25.00 reinstatement fee.

Full Name

Current Phone Number

Current Email Address

Maiden Name (or any other name you would have had previously as a member)?

What is your date of birth?

What status are you reinstating as:

Are you reinstating in order to transfer your membership?

If yes, where are you transferring to?

Approximate Active Date:

Approximate Date you no longer were a member of JLN:

Additional Comments

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