JMLBA Membership Form

Membership Year: July 1, 2016 to June 30, 2017

Use this form if you are a
*new member,
*renewing member, or
*current member who would like to update your contact information.

Please note this form has three parts: Contact Info, About You, and Membership Level.

You must click "Submit" at the end for us to receive your membership application.

    PART 1. CONTACT INFO

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    Office Contact Information

    We ask for both you office and personal contact information, but we will contact you via your preferred method. We will use the other information if we cannot reach you using your preferred contact information. This is helpful if you move, but forget to update your contact info with us.
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    Must be a valid email address
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    Please enter using the format 000-000-0000
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    Personal Contact Information

    Home, etc. We ask for both you office and personal contact information, but we will contact you via your preferred method. We will use the other information if we cannot reach you using your preferred contact information. This is helpful if you move or change jobs, but forget to update your contact info with us.
    This is a required question
    This is a required question
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    Must be a valid email address
    This is a required question
    Please enter using the format 000-000-0000
    This is a required question
    Please enter using the format 000-000-0000
    This is a required question

    Contact Preferences

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    Contact Opt-In

    JMLBA sends a weekly e-newsletter and periodic emails related to JMLBA and other events and programming we believe would be of interest to JMLBA members and supporters. We may use a third-party, such as, but not limited to, Constant Contact, to send these email messages. In the past, everyone has wished to receive these emails. JMLBA may send text reminders of our upcoming events. These will be infrequent reminders, e.g., on the day before or day of an upcoming JMLBA meeting or event. On occasion, we may send text reminders of non-JMLBA events, such as Election Day. We may use an auto-dialer or third-party to send these text messages. You are solely responsible for any charges associated with receiving these text messages. You are not required to consent to emails or text messages as a condition of joining JMLBA or participating in JMLBA programs. By selecting "YES" below, you authorize JMLBA to deliver these types of messages using these methods to the email address and/or mobile number you provided herein.
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