Polish Canadian Jazz Society - Membership application

*Membership Application

All members are required to adhere to the Polish Canadian Jazz Society's Constitution and Bylaws. The Application should be accompanied by payment for the Membership annual fee of $25 - cheque payable to PCJS.

Applicant's Name

Address

Unit:
Street:
Postal Code:

Phone:

City:
Province:

E-mail: A value is required.Invalid format.

Applicant's signature

Date

Application received by

Date

Application approved by

Date