Application form - Dues are for 1 year -  Renewable January

New Member Renewal

		Class of
Name
Name
Address
City
State	Zip
E-mail
Tel
How many?	@ $10.00 = total
Contribution to Scholarship Fund
Memorial in honor of
	TOTAL

Enter any your comments you want to make:

COMPLETE THE FORM ON-LINE, PRINT USING YOUR BROWSER PRINTER, MAKE YOUR CHECK OUT TO AND MAIL:

JHS ALUMNI ASSOCIATION

CORYDON IN 47112-0524