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.