Page 156 - The Jazzsipper Novel

Complete the survey below to be notified when JMAT 4 Youth Small Community Organizations/Societies
Strategic Alliance formation registration begins.

What to do next? Spread the word about JMAT 4 Youth to your prospective members. We’ll notify you by
email when registration begins in the Fall of 2017, and how you and your members can sign up.
If you have any questions in the meantime email them to info@jmat4youth.com

I am interested in forming a new: *

Small Community Organization Strategic Alliance

Jazzsipper Society

Current Small Community Organization, or Jazz Society interested in forming a: *

Small Community Organization Strategic Alliance

Jazzsipper Society

Are you a current Member of a Small Community Organization or Jazz Society? *

Yes

No

Are you starting a new Small Community Organization or Jazzsipper Society? *

Yes
No

ORGANIZER INFORMATION
Organizer Email * _____________________________________________

Organizer First Name * _____________________________________________

Organizer Last Name * _____________________________________________

Organizer Phone ** _____________________________________________

COMMUNITY ORGANIZATION OR SOCIETY INFORMATION

Number of Potential Members ** _____________________________________________
Community Organization/Society ** _____________________________________________

Enter the name of your church, high school, or social media community group*____________________

Location City ** _____________________________________________

Location State * _____________________________________________

Location Post/Zip *_____________________________________________

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