Editor, Webmaster:  Phil Cartwright   Editor@earlyjas.org
Membership Form
We don't have on-line Internet membership enrollment.  Please print this
form or just write a letter to the EARLYJAS Secretary, address below.
NAME: ___________________________________________________________________
(Include second name if couple/family membership)

ADDRESS: ________________________________________________________________

CITY: _________________     STATE/Province________________  ZIP: __________

TELEPHONE: ___________________   EMAIL: ______________________________


Single membership $20.00 _________            Family membership $25.00 __________
                                For family members at same address.

Are you or any family members musicians?    Yes _____    No _____

Instrument(s) _____________________________________
Do you want to receive the EARLYJAS Rag by US Mail?____  Or by email? _____
Suggestions for future programs: __________________________________________
_________________________________________________________________________
_________________________________________________________________________
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Mail Membership Form and check to:  EARLYJAS, PO Box 1621, Kent, OH  44240
Questions?  Email editor@earlyjas.org     or call 330 678 5903
EARLYJAS
Earlville Association for Ragtime Lovers Yearning for
Jazz Advancement and Socialization