Feather River Dixieland Jazz Society
Membership Application
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Please make check payable to:
Feather River Dixieland Jazz Society
PO Box 667
Graeagle, CA 96103
Please check to indicate your membership preference:
Per Year Charge at door
___ Sponsor + family $80 None
___ Couple 14 each $3.00
___ Individual 8 $3.00
___ Student 3 $3.00
___ Notes only 3 ----
___ General Public 0 $10.00
Name: _________________________________________ Date_______________
Address: __________________________________________________________
City, State, Zip: ________________________________ Phone: _______________
E-mail Address: _____________________________________________________
I will help with:
___ Hall setup & cleanup ___ Distribute posters
___ Food Booth ___ Picnic Grounds cleanup
___Publicity Chairman ___ Board Member
___ Other ________________________________________________________
To print: On your keyboard press
CTRL and P simultaneously