Just print and fill out this form, then mail it to:

The St. Augustine Jazz Society
P.O Box 1505
St Augustine, FL 32085

See calendar on www.staugustinejazzsociety.net for events & locations.
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DATE____________ RENEWAL___ NEW MEMBER___

NAME______________________________________

ADDRESS___________________________________

CITY___________________________STATE_______

ZIP CODE______________PHONE________________

E-MAIL______________________________________

Check one: Cash __ Check __Number:_______

Enclosed is a contribution in the amount of $__________ for:

Sponsor $300 ~ Patron $100 ~ Donor $50 ~ Family $25 ~ Individual $15
Student $5

The Society could use your help.
We are in need of volunteers if we are to keep the Jazz Society active.
Please let us know if you would be interested in...

__ Newsletter __Membership __Publicity __Board Position __Other

Remember, joining or providing donations go to for student
tuiton grants and they are tax decuctable.