IAJE Membership Application Form

DUES

Active Membership- $68.00 Student Membership- $30.00

Retired (Age 62 minimum) -$60.00

New

Renewal

Name:

Address:

City:

State:

Zip: Country:

Daytime Phone: Home Phone:

E-Mail: Fax Number:

I wish to make an additional contribution to IAJE.
$

Total Amount Enclosed

Send Check or money order to:

IAJE
PO Box 724
Manhattan, KS 66505

Register by phone with Credit Card by calling (785) 776-8744

Fax with Credit Card information to (785) 776-6190

 

 

 

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