The Japan America Society of Vermont
Dedicated to Improving Cultural Understanding and Business Interaction
123 Ethan Allen Avenue, Suite 306 - Colchester, VT 05446 - U.S.A
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Membership Application

Yes, I / we would like to join!



City, State, Zip:



Membership category:


Household/Individual ($25)


Non-profit organization ($25)


Senior Citizen (60+) ($10)


Student ($10)


Sponsor ($50)


Patron & Corporate ($100)


Life Time Membership ($1,000)

Participation: Are you interested in helping out during some of the JASV events? May we contact you about this? [__] Yes, [__] No.?

Employers will often match individual employee gifts. Will yours?

Please make your check (tax deductible) payable to the Japan-America Society of Vermont and send it to

Japan-America Society of Vermont
123 Ethan Allen Avenue, Suite 306
Colchester, VT 05446.

[__] Please send information on corporate membership.

[__] Please send membership information to the following person(s)

Thank you!

Last update: 2013 September 2013