application

Jacksonville Alumnae Panhellenic Membership Application

(Once completed, please be sure to hit "Submit" button at the bottom.)

Name:

First

Last

Address:

Street

State

City

ZIP

Sorority:

College/University:

Please make check payable to Jacksonville Alumnae Panhellenic Association and mail to:

JAPA Membership

2233 Saye Drive East

Jacksonville FL 32225-4862

Thank you for your interest and participation!

If you have any questions about membership, please email extexans@comcast.net

Email address:

Preferred method of contact:

Maiden

Number of years in JAPA

Spouse's Name:

Home phone:

Work phone:

Occupation:

Employer:

Membership Dues:$30

Scholarship Donation: $

in memory of

in honor of

Directory Ad: $

business card @ $10

1/2 page @ $20

full page @ $40

(Directory Chair will contact you regarding copy.)

Total JAPA Support: $

Scholarship Fund Recognition Levels:

Supportive Sister$15 - $24

Generous Greek Giver$25 - $49

Panhellenic Patron $50 - $74

Athena Society $75 +

Birthdate:

Month

Day

You can also pay through PayPal using your debit or credit card.