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MEMBERSHIP

Online Membership Form

Complete the online membership form below and indicate your committee interests. We will contact you via e-mail with more information about the committees in which you are interested. You can also download our paper membership form and send it to us.

Please note, the name, areas of interest and comments are required fields and marked by *.
Your application will not be sent if these fields are not completed.

Membership Form

*Last Name:	*First Name:	Date of Birth:	Sex:


Home Address:	Home City:

Home State:	Home Zip:	Home Phone:


Work Address:	Work City:

Work State:	Work Zip:	Work Phone:


Email:
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Why JamPact:
We have several committees . Please indicate your area(s) of interest. CommunicationEducationFundraisingMembershipThink Tank
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