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Japanese Art Society of America Membership Form Print E-mail

To fill out our membership form, click on the Printer icon at right. JASA iconYou can type directly into the boxes on the pop-up form, then print out the form using your browser's print button. Sign (if using a credit card) or enclose the check for your membership fee, and mail to:

Attn.: Administrative Secretary
Japanese Art Society of America, Inc.
P.O. Box 665, FDR Station
New York, NY 10150

For your convenience, you may attach an address label or business card rather than writing your address.

Title:      Dr.     Mr.     Mrs.     Ms.

Name(s) of Dual/Family Members

Street Apt. #

City State Zip Country

Daytime Phone Evening Phone

Fax E-mail Address

Are you willing to be a volunteer?    Yes  No
Are you willing to receive notices of lectures and other events by e-mail?    Yes  No
Are you willing to receive our quarterly newsletters by e-mail?  Yes  No
Would you like to have your contact information included in the membership directory?  Yes  No

Membership Levels

$40
$75
$100
$100




Additional contribution:
$

Payment

Credit card payments will be accepted, but checks in US$ preferred. International Members, please pay by a check drawn on a U.S. Bank or international money order or by Visa/MasterCard.

My check is enclosed   
Charge my Visa   Charge my MasterCard

Card Number

Expiration Date

____________________________________________________
Signature

The Japanese Art Society of America, Inc., is a Not-For- Profit 501 (c) (3) Exempt cultural and educational
organization. Memberships and contributions are tax deductible to the extent permitted by law.