Membership Form

Please send your $60.00 per person check ($120.00 per couple) to:

DFJCA

P.O. Box 25068

Scottsdale AZ 85266

Your payment is now due. Please indicate any changes in your information on the form below.

Name______________________________________________________________

Address____________________________________________________________

Phone_________________________ Cell ________________________________

Email______________________________________________________________

______I am/we are interested in becoming more involved in DFJCA

We are a 501c-3 Religious Organization. Your dues payment is a charitable donation to the extent of 80% of your payment.

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