P.O. Box 245    Waterloo, IA 50704

Canoe Race
• 30th Annual Canoe Race -
• June 12, 2010 Click Here

• 2010 Saturday, July 3rd
6:00p.m.-midnight Click Here

• 2010 Waterloo Open
   July 14-18 Click Here
Gift of Giving -
Dec 4, 2010 Click Here

Application for Membership

Name
Spouse (if applicable)
Address
City, ST Zip
Home Phone  
Work Phone  
Email
Date of Birth (if applying for membership) "> %>
Employer (if applying for membership)
Job Title (if applying for membership)
Referred By
I would like to refer
Refer Phone  

Check all that apply:

Yes, I want to be a member and will pay by credit card
       my $60.00 membership fee, plus $2.00 credit card processing fee.

Yes, I want to be a member and will mail my $60.00 membership fee.

Send me more information on Waterloo Jaycee Membership.

Have a member call me about becoming a Waterloo Jaycee.

                   

 

If paying by mail, please mail your annual $60.00 membership fee to:

Waterloo Jaycees, P.O. Box 245, Waterloo, IA 50704

Dues for your Jaycee membership are NOT tax deductible as a charitable contribution.

Membership Vice President - Laura Kann, email - info@waterloojaycees.org
Site created and powered by VGM Forbin. Copyright 2005 : Waterloo Jaycees. All Rights Reserved.