Thank you for your interest in joining The WellHouse Junior Board!

Please fill out the following information:

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

###

####

Occupation

Employer

How did you first hear about The WellHouse and what led you to get involved?

What is your current understanding of human trafficking?

Please describe any previous/current Junior Board or volunteer experience (can be specific to The WellHouse and/or other organizations).

Who is recommending you for Junior Board membership?

Are you committed to fulfilling the obligations required of a WellHouse Junior Board member?