Membership Registration Form

*Your name, phone and valid email address are required items on this form.

Form Instructions: Complete the appropriate information and press the “Submit Membership Registration” button below when complete. After submitting this form, mail your registration payment to:

DFJCA
P.O. Box 25068
Scottsdale, AZ 85255

Membership Fees: $75.00 per person (or $150.00 per couple)

     

    I am/We are interested in becoming more involved in DFJCA.

    I am/We are interested in making an additional donation to cover programs.

     

    Privacy Statement: We ensure your privacy. We will not sell or rent your name or any information you provide to us.

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