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Japanese
American Citizens League
Florin Chapter Membership Application
I.
Member Info
New Member / Renewing Member (please circle membership type)
First Name:_________________________________________
Last Name:__________________________________________
Street Address:________________________________________
City: __________________ State:______ Zip Code: _________
Age: ______ Occupation:__________________________________
Home Phone Number: (
)___________________________
Work Phone Number: i(
)___________________________
E-Mail Address:________________________________________
Would you like to join JACL's e-mail list? Y / N
Are you a Registered Voter? Y / N
What are your interests?_________________________________
What attracted you to JACL?_____________________________
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1 of 3 of Membership Application
II.
Membership Type
(please circle the membership you are interested in)
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Individual
- $63
Regular sustained members of the organization.
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Couple/Family
- $108
Membership for an individual, their spouse/partner and any
children less than 25 years of age.
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Youth/Student
- $25
Member 25 years or younger or is currently enrolled in a
college, trade school, or university.
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Associate
- $10
Members that belong to another JACL chapter as their
primary chapter, but would like to support the Florin
Chapter and/or would like to keep informed about Florin
JACL activities.
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Thousand
Club - $100
A membership category where members make a larger annual
contribution to their chapter and national programs of the
organization.
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Thousand
Club Life - $3000
Member who pays a lump sum to establish a lifetime
membership.
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Century
Club - $175
An exclusive membership category where members make a
larger annual contribution to their chapter and national
programs of the organization.
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Century
Club Life - $5000
An exclusive membership where a lump sum is paid to
establish a lifetime membership.
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Thousand
or Century Club Spouse - $32
Spouse
of Japanese American Citizens League member who belongs to
the Thousand or Century Club.
Millennium
Club Spouse - $36
Spouse
of Japanese American Citizens League member who belongs to
the Millennium Club.
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Millennium
Club - $1,000
Much
like the Century Club and Thousand Club, Millennium Club
is designed for individuals who wish to significantly
contribute to better assure that JACL continues to
promote, sponsor and encourage programs, projects and
activities to
secure and uphold civil and human rights for all people.
This is an annual membership category.
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2 of 3 of Membership Application
III.
Payment Method
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Make checks payable to: Japanese
American Citizens League.
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IV.
Complete Application Process
To complete the application process, please mail the completed
application, along with payment to:
Japanese
American Citizens League, Florin Chapter
PO
Box 292634
Sacramento,
CA 95829-2634
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