P. O. Box 1727,
Spring Valley, NY 10977
Phone: (845) 425-7327 / (845) 362-0630
Website: http://www.planet-rockland.org/jamccar/

Membership Enrollment / Renewal Form

Please print this form and mail it in with your check.
Check here if address is changed.

Name(s):
Address:
City: State: Zip Code:
Phone: (       ) E-mail Birthday: Month      Day
Recommended by:

 

Annual Membership Dues paid:
Individual ($30) _____ Family ($50) _____ Young Adult ($10) _____ (16-25 years old) $ __________

Optional Contributions:
Scholarship Fund $ _____ Building Fund $ _____ Operating Fund $ _____ $ __________

  		Total $ __________

Children (Name, Date of birth):


I would like to work with the following Committee(s): (Please circle)

Program       Membership       Public Relations       Hospitality       Fund Raising       Audit
Outreach       Building       Scholarship       Sports & Recreation       Rules/Parliamentary


Other activities:
Folk Singing ___ Soccer___ Cricket ___ Drumming ___ Steel Band ___ Drama ___ Other _____________

Signature:
Our monthly meeting is on the second Friday of each month at 7:30 p.m. at
The Louis Kurtz Civic Center, 9 North Main Street, Spring Valley.

Benefits of JAMCCAR Membership

Objectives of JAMCCAR

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