JCESBA Membership Renewal Form

Renewal - Membership Types

Select membership type & provide payment
Business Memberships are for businesses.
Residential Memberships are for single individuals or households only.

Renew my membership:

Business Membership: $50.00

Annual Membership

Residential Membership: $15.00

Annual Membership for single individuals/households ONLY.

(Optional) Freedom Corner Veterans Memorial Donation$25.00

This is an optional donation that will be allocated to ongoing maintenance, insurance premiums, routine expenses, and general upkeep of Freedom Corner Veterans Memorial. Please select the quantity below to note your donation amount (up to $500). Each quantity equals $25 (quantity 1 = $25, quantity 2 = $50, etc.). If you would like to donate more than $500, please reach out to Brad Shimmens at bshimmens@jcebsa.org. Note * Please see link to the Freedom Corner Veterans Memorial below payment.

Quantity

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Freedom Corner Veteran's Memorial
Member Information
Business Name
If you are a Residential member, please enter your name here: i.e. - Last Name, First Name
Your Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
I am interested in being a potential host for a membership meeting at my location. We would need space for 30-40 people. Business will have the opportunity to address membership for 3 minutes. (Answering "Yes" may not guarantee a hosting opportunity in the calendar year.)
If yes, Fill in location name and address.
I would like my company/organization to be featured in a monthly member spotlight on social media (limited to 12 responses).
If yes, Type 2-4 sentences about your company/organization to be used in the post.
If yes, include image or logo.

Browse Files
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To ensure our website is up to date with your current members logos, please provide here if you would like to add to website.

Browse Files
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Renewal - Membership Types

Renew my membership:

Member Information