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LAJE MEMBERSHIP
APPLICATION
NAME:_____________________________
HOME ADDRESS:______________________________
City:__________________________ State:________ ZIP CODE:___________
EMAIL: Home_______________________ Work________________________
TELEPHONE: Home____________ Work_____________
SCHOOL:________________________
ADDRESS:_______________________
CITY:___________________________ State_______ ZIP CODE:__________
Enclosed is a $25.00 Check____ Money Order____
Please enclose check or money order for $25.00
Payable to: Louisiana Association for Jazz Education
Mail to:
Galindo Rodriguez
LAJE - Treasurer
School of Creative & Performing Arts
Northwestern State University
Natchitoches, La. 71457
Thank you for supporting LAJE and jazz educaction in Louisiana!!!!
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