Al Jolson Home Page|The IAJS|Renewal

The International
Al Jolson Society

MEMBERSHIP RENEWAL FORM

This form is for renewal of existing membership of the International Al Jolson Society. New member applications should use the new member application form. Current dues is US$25 (UK£16). Send your dues, drawn on a US bank, to the treasurer at:
US and non-UK
UK
Sandra K. Gerloff
419 Glenwood Drive
Douglassville, PA
19518
USA
David McCarthy
87 Brocket Way
Chigwell
Essex
IG7 4EU

or you can pay by credit card via PayPal. Payment submitted over the web will have a $1 processing surcharge added. Please be sure to fill out all blanks, including your Email address, so that I can acknowledge your submission!



* Required fields
            Name: *
  Street address: *
                  
            City: *
  State/Province: *
        Country*:  *if not US
 Postal/ZIP Code: *
       Telephone: ( )  ext: North America only
                  ++-  ext: outside North America
   email address: *
      occupation: 
       birthdate: 
Any comments? Any news or questions?  
 
Please indicate payment method
Check or Money Order via Snailmail . . . . . . PayPal via web
[PayPal link for payment on the next page]


Thank you for your information, please press the RENEW button
to send the information to the International Al Jolson Society.


If you came here from a link or search engine
Click here to return to the main page of this site

This listing and material Copyright © 1995-2011 Marc I. Leavey, M.D. Baltimore, Maryland
Updated 13 Nov 11