ADSJ ANNUAL DUES PAYABLE ON OR BEFORE JANUARY 1

Member’s Name(s) ___________________________________________________________

Address _____________________________________________________

City __________________________ State _________Zip____________


______ Single Membership dues: $40.00
______ Joint Membership: $70.00


$5.00 discount per person if paid by January 1st
Please make check payable to ADSJ, in US Funds payable at a US Bank and return it with this form to:

Carl G Liepmann, Secretary
9144 W. Mt Morris Rd
Flushing, MI 48433


YOU MAY RENEW YOUR DUES BY PAYMENT THROUGH PAYPAL (with PayPal fee added) USING ANY OF YOUR CREDIT CARDS.

ADSJ Dues; Payable by December 31 for the following year.

Please select one of the options below:

Single Membership before Jan 1: $37.00
Single Membership: $42.00
Joint Mambership before Jan 1: $64.00
Joint Membership: $74.00

Options