WELCOME NEW MEMBERS

MEMBERSHIP APPLICATION / RENEWAL

Date: _____________

New: _____ Renewal: _____    

Name(s): _________________________________________________

Address: ___________________________________________

City: _____________________________  State: ____________

Zip: ____________  Phone: _____________________________

email address: _______________________________________

​Check circle one: Patron - Family - Individual - Corresponding (Newsletter Only)

Would you like to be a volunteer? If so, please indicate in what capacity:

_______________________________________________________

Referred by (if applicable) ___________________________________

Please complete the application / renewal form and make check payable to the SUNCOAST DIXIELAND JAZZ SOCIETY, INC. and mail to:

SUNCOAST DIXIELAND JAZZ SOCIETY, INC

P.O. Box 1014

Largo, FL 33779-1014

  ANNUAL DUES:

​
Patron (Couple or Individual)                          $125.00 

Family (Couple)                                                  40.00

Individual.                                                           30.00

Corresponding (Newsletter Only)                       25.00

Student (Full-time) with student card    ..       No charge​

JOHN LAMB

ROBERT SULLIVAN

JAY HART

BETTY SNODGRESS

LAURA RUETERFORS

​LUANNA FROLICK

OWEN & NAN HOLZBORN

JOE WALL

STEVE MAKOWSKI

BILL & JAN HARROUN

​

Thank you so much for joining the Suncoast Dixieland Jazz Society. It's because of folks like you that enable us to continue with such a wonderful art form. We look forward to seeing you at many of our upcoming events.