JCA Membership Application

The Jewish Community Alliance is a membership organization. Its primary purpose is to provide programs through which Jewish identification and physical, social and emotional development of the individual may take place. JCA membership is open to all who understand and support its purposes.

Membership in Name of

First Name

Last Name

Sex

Male
Female

Birthdate

Address

City

State

Zip code

Business Name

Home Phone

Business Phone

Cellphone

E-mail Address

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Spouse

First Name

Last Name

Sex

Male
Female

Birthdate

Business Name

Business Phone

Cellphone

E-mail Address

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Dependent children (23 years old & younger)

Name

Sex

Male
Female

Birthdate

Additional Children

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I/we are applying for membership at the JCA for use of its facilities, subject to the rules and regulations established for the JCA by it Board of Directors.

I/we have read and understand the following:

A registration fee is required for all those applying for membership. This fee is not applied to dues.
Membership is for a minimum of 12 months. Dues are to be either paid in full at the time of joining or extended payment plans may be arranged using automatic debit from checking accounts or automatic charges on your Visa or MasterCard. Membership will remain in effect unless I/we notify the JCA in writing with 30 days notice after the initial 12 months.*
Membership fees are not transferable or refundable.
Membership services may be modified by the JCA.
Membership may be suspended or revoked if an individual does not comply with policies, rules and practices of JCA.
JCA reserves the right to raise dues as necessary.

After we receive your online application, we will contact you to make an appointment for you to sign the application and make payment arrangements.

*30 days from the end of the month nofitication was given.