Membership Renewal Form This form is only for membership renewals. For new members, please use the New Member Application. Required fields are marked with an asterik *. Society Information Name of society * Society mailing address * City * Postal code State/Province Country * Email address * Web site Publication name Publication frequency Please signify if a member of another organization and give name Officer Information Society President’s Name * President’s Email * Society Treasurer’s Name * Treasurer’s Email * In what month are officers usually elected? * Membership Fees Number of members at the end of the current year * Membership fees (use the larger sum) Number of members x US $.50 = US $ or Minimum Membership Fees = US $18.00 I hereby certify that the number of members reported is true and correct. * Date * Officer’s (Digital) Signature * (Please type your name to indicate your digital signature.) Officer’s Title * Officer’s Email * (This email will be used to send a confirmation.) Payment Annual fee for IAJGS Membership * Contribution to the Rabbi Stern Grant Contribution to the Travel Fund Total Payment * Payment Method Payment may be made by either check, PayPal, or credit card. Checks must be in US dollars and drawn on a US bank. We encourage our non-US members to use PayPal or credit card. Check Checks may be mailed to: Douglas M Cohen IAJGS Treasurer 1800 Ben Franklin Drive A1002 Sarasota, FL 34236 USA PayPal or Credit Card After submitting this form, you will be provided a button to submit your Paypal/credit card payment to email@example.com. Please include the name of your JGS and your membership count in the message box.