MEMBERSHIP APPLICATION
 
Print this form and mail to:
SJAC
PO Box 563
Haddonfield, NJ 08033
 
___ New Member ___Renewal ___Change
 
Membership Type:
___ Individual ($20.00) ___Family ($25.00)
 
Optional - SJAC Unisex Cotton T shirt - ($10): S__ M__ L__ XL__

 

Total Paid: $__________
 
________________________________________________________
Last Name First Name MI
 
_____________________________________________________________
Street Address
 
_____________________________________________________________
City State Zip
 
Gender: ___ Male ___ Female
 
Birth Date: ____ / ___ / ______
month - day -- year
______________________________________________________________
email address (most club info is distributed by email)
 
Phone No.(s) you want us to use:
Home: __________________________________
Work: __________________________________
Cell: ____________________________________
 

Any areas of the club in which you are interested in getting more involved
(use back if needed)?

Competition ___ Social Activities___ Publicity/Community Outreach___ Other___

 
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