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Member

1. First Name
2. Last Name
3. Street
4. Apt/Suite#
5. City
6. State
7. Zip
8. Email
9. Home Phone
10. Membership Type
11. New
12. Renewal
13. Membership Level
14. MAJC Membership  $100
15. Under 35  $35
16. Sustaining Membership  $150
17. Contributing Membership  $200
18. President's Council  $1,000
19. Founding Membership  $5,000
20. Amount $100.00

1. 

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