Membership Application Form


	Jazzphil Annual Membership Fee: Local: 750 Php. International: 950 Php If you are remitting in U.S. currency, please use the exchange rate of 56 Pesos = $1.00. If remitting in Euros, use the exchange rate of 68 pesos = 1.00 Euro How to pay: After successfully filling out the membershipship application form below, you will be shown a confirmation page indicating how and where to remit your payment. Once payment is received, you will be notified by the chair of the Membership Committee of your acceptance. We thank you for joining!

		This application form is no longer functional.

Jazzphil Membership Application Form

Contact Information

Email:
(from)
Last Name:
(required)
First Name:
(required)
Company Name:

Residential Street Address:
(required)

City:
(required)
State/Province:
(required)
Postal Code:
(required)
Country:
(required)
Landline Telephone:

Cellular Telephone:

Web Homepage:

Date of Birth:

General Interests

Traditional: Swing: Bop: Post Bop: Fusion: Avant-Garde: Electro-Acoustic Improv:

Who are your favorite JAZZ musicians, bands?:

If you specialize in an artist, label, composer, composition, format or era, please indicate here:

DESCRIBE YOUR COLLECTION HERE: Click relevant checkboxes and type in numbers for each.

CDs LPs CASSETTES VHS

LD/DVD/VCDs MP3s 78RPMs 45RPMs

MINIDISCs BOOKS MAGAZINES

POSTERS/MEMORABILIA OTHERS

DO YOU WANT TO EXCHANGE TAPES/CDRs WITH MEMBERS? YES NO

COLLECTING ACTIVITES: DO YOU WANT TO: BUY SELL TRADE?

DO YOU WANT TO CORRESPOND? YES NO IF “YES”, BY LETTER E-MAIL "TEXT"

OTHER COMMENTS/INTERESTS:

INTERESTED IN HELPING WITH A JAZZPHIL TASK/JOINING A COMMITTEE?
(Ways and Means, Public Relations, Newsletter, Membership and Events, and Website Committees)