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Japan America Society of Maine
MEMBERSHIP APPLICATION
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 payable
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
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