Individual/Couple/Student Membership Form

(407) 603-5623 -- Jamaican Cultural Connection -- A 501(c)(3) Organization getjccinfo@gmail.com

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- Business / Non-Profit Org. Membership Form
- Individual/Couple/Student Membership Form

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Fill out this section if applying for Individual, Couples, or Student Membership
- Student Membership
- Individual
- Couples
*For couples, please place only both first names separated by the word "and".
Name
Mailing Address
City
State
Zip Code
Phone(DAY)
Phone(Evening)
Cell Phone
Email
Are you currently enrolled in College
- Yes
- No
If YES, Which College
Interested in doing Voluntary work?
- Yes
- No
Interested in serving on a commitee?
- Yes
- No
If Yes, Which of the following:
- Membership
- Entertainment
- Election
- By-Laws
- Young Leaders
- Education
- Health Care
- Food Pantry
- Youth Development
- Ministry
If Yes, Which of the following:
- Membership
- Entertainment
- Election
- By-Laws
- Young Leaders
- Education
- Health Care
- Food Pantry
- Youth Development
- Ministry
Any Special Skill
Special Interest
Sponsor's Name
Charity
- Food Pantry
- Health Care
- Education
- Youth Development (M)
- Youth Development (F)
- Ministry
Monthly Pledge
- $ 5.00
- $ 10.00
- $ 15.00
- $ 20.00
- $ 25.00
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After you submit your application, please pay your dues by selecting your application type from the PayPal button below.

Membership Options

(Virtual Meetings Only – See Members Meeting Page for more info)

Time: 5:00 P.M.
Last Sunday of the month.

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