Annual Membership Renewal Report Required fields are marked with an asterisk *. Membership Renewal Application Are you renewing as an Associate or Regular Member? * Regular Associate SECTION 1: ORGANIZATION INFORMATION Name of Organization* * If the organization is part of a larger organization such as: historical society, museum, JCC, synagogue, genealogical society, etc. Please give its name Organization's mailing address * City * State * Postal Code * Country * Email * Website/URL Publication Name Publication Frequency Publication Editor Email - Pub editor SECTION II: ORGANIZATION OFFICER INFORMATION President Name * President's email address * Phone President May we print phone number in IAJGS directory? Yes No Treasurer * Treasurer's email address * In what month are officers usually elected? January February March April May June July August September October November December SECTION III: MEMBERSHIP FEES (Regular Member) Enter number of members at year end Annual dues at 50 cents (US$) per member (minimum of $18) You will be taken to Payments after you submit this form SECTION IV: PAYMENT 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. After submitting this form, you will be provided a button to submit your Paypal/credit card payment. Once on Paypal, you may need to scroll down to pay by credit card. Annual Fee or Regular IAJGS Membership from above * Associate Fee Malcom Stern Fund Donation Travel Fund Donation Total Payment (calculated) Submitted by Email SECTION V: PAYMENT METHOD Choose One Check Credit Card Checks may be mailed to: Douglas M Cohen IAJGS Treasurer 1800 Ben Franklin Drive A1002 Sarasota, FL 34236 USA First Name on credit card * Last Name on cc * Credit Card * Address * Address Address Address City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country If you are human, leave this field blank. Submit & Pay
