Last Name__________________________ First Name_______________________
Address_________________________________________________________________
City_____________________________ State___________Zip_____________________
E-mail Address__________________________________________________________
Best Phone # (_____)________________
If a Family Plan – Members Names Relationship
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2025 Dues
- Regular Member ……………………. $20.00 ___________
- Family Plan ………………………..….… $30.00 ____________ (Regular Plus Unlimited Family Members)
- Junior Member ….……………….… $15.00 ____________ (17 & under)
- Senior Member 1st Year …..…… $20.00 ___________ (Over 65 after)
- Senior Member Renewal……….. $13.00 ____________
Total Amount Enclosed $__________ Date: _______________
Make checks payable to SJMDC and mail to:
SJMDC Membership – PO Box 365 – Port Norris, NJ 08349
Visit our website at www.SJMDC.org for information on meeting times, etc.