Inku
Japan Society of Fairfield County
2013 Membership Application

Membership Information
The Japan Society of Fairfield County, Inc. is a non-profit organization. Your membership dues are the prime source of our operating funds. Members are entitled to reduced rates to participate in JSFC programs and are added to our mailing list to receive individual notification of programs.  Some programs, such as our movie program, are limited to members. (Cancelled:Our members also have reciprocal membership privileges with the Hammond Museum and Japanese Stroll Garden in North Salem, NY. ) To provide the programs for members and the community and to fulfill our mission, we urgently need your support. Please be as generous as you can. Japan Society of Fairfield County, Inc. is a tax-exempt organization under section 501(c)(3) of the Internal Revenue Code , and a public charity described in section 509(a)1 of the Internal Revenue Code and contributions are tax deductible to the extent allowed by law. (Federal I.D. Number 06-1219643) The membership year begins and ends with the calendar year.  In a member's first year, dues are prorated quarterly.  Those who join in the first 3 months pay full dues,  see below for first year dues when initially joining later in the year.

SPECIAL MEMBERS    REGULAR MEMBERS
(corporate or individual)
Friend $500+ Family $40
Patron $300-$499 Individual $25
Benefactor $100-$299 Student $15

All checks should be made payable to: Japan Society of Fairfield County, Inc.
For additional information, please call Vernon Beck-President JSFC, at 203-431-0697, or email him
Mail new memberships and renewals to: JSFC Membership, c/o Mithat Mardin, 985 Old Coach Road, Orange, CT 06477

Name (first, last):

Spouse Name:
 
Children (names and ages):
 
Mailing Address:

Phone: Home: Business:  Fax:  

email (please print clearly):

Company Name and Title (If applicable):

Amount of check (enclosed): $ ________ Membership Type: ________________ ❏ Renewal membership ❏ New Member
Areas of interest in which you would like to volunteer: ❏ Membership ❏ Newsletter ❏ Program ❏ Hospitality
How did you find out about this Society?

What type of programs would you like to see the Society present?

Comments:

________________________________________________________________________________________________
New members, please mail your completed Membership Application with your check to:
JSFC Membership
Mithat Mardin
985 Old Coach Road
Orange, CT 06477

Dues for joining April-June
SPECIAL MEMBERS    REGULAR MEMBERS
(corporate or individual)
Friend $375+ Family $30
Patron $225-$374 Individual $18.75
Benefactor $75-$224 Student $11.25

Dues for joining July-September
SPECIAL MEMBERS    REGULAR MEMBERS
(corporate or individual)
Friend $250+ Family $20
Patron $150-$249 Individual $12.50
Benefactor $50-$149 Student $7.50

Dues for joining October-December
SPECIAL MEMBERS    REGULAR MEMBERS
(corporate or individual)
Friend $125+ Family $10
Patron $75-$124 Individual $6.25
Benefactor $25-$74 Student $3.75
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