J
Japan America Society of
Maine MEMBERSHIP APPLICATION
FORM
NEW ___
RENEWAL___
Date
_________________
Name(s)
______________________________________________________________________
Address_______________________________________________________________________
Tel ( )
; Fax (
)
; E-mail _______________________
Membership type:
Individual ($30) ___ ; Family ($40) ___ ; Student ($15) ___
ENCLOSED (please make your check payabe to JASM):
(MEMBERSHIP) $ ; (CONTRIBUTION) $
; TOTAL:
$_______________
*
Why did you decide to join JASM?
*
What do you want to get out of your JASM membership?
*
What are your JASM program and activities interests?
*
Are there JASM activities or programs for which you are
willing to volunteer?
Please return the application form and your check
to:
JASM, P.O. Box 8461, Portland, ME 04104-8461