Inku
Japan Society of Fairfield County
2008 Membership Application

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:
Japan Society of Fairfield County, Inc.
c/o Harry Sakamaki, President
140 Field Point Road #8
Greenwich, CT 06830

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. 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. Contributions and membership dues are tax deductible. (Federal I.D. Number 06-1219643) The membership year begins and ends with the calendar 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 Harry Sakamaki-President JSFC, at 203-912-3757, or email
Mail new memberships to: Harry Sakamaki-President JSFC, 140 Field Point Road #8, Greenwich, CT 06830
Mail renewals to: Joyce Shinomiya-VP Membership, PO Box 65, Greens Farms, CT 06838
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