Membership Enrollment

To become a member of the Alexandria Jaycees please come to one our general meetings.

WHEN: General meetings are held the second
Tuesday of each month.
WHERE: Glenwood State Bank (Alexandria Location)
6:30pm

If you have questions, you may E-mail us at alexandriajaycees@gmail.com
or call (320) 834-3030.

To become a member please fill out the information below.

First & Last Name (required)

Your Email (required)

Home Address (required)

City (required)
, Minnesota
Zip Code (required)

Phone (required)
xxx-xxx-xxxx
Birthday (required)
MM/DD/YYYY
Married? (required)

Spouse's Name

Employer

Address

City

Zip Code

Work Phone
xxx-xxx-xxxx
Send Mail To?

Areas Of Interest

Dues are $70.00
For Payment (required)

Agreement (required)
 checked means you agree
By checking the box, this is used as your "digital" signature. You are agreeing that the information you provided above is accurate to the best of your knowledge.
Note: You MUST agree for your application to be submitted.

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