Membership Form Simply complete and submit this membership form to become a JAA member. Membership Category Membership CategoryRegular — $100Regular Spouse — $50Senior (over 65 years) — $60Senior Spouse — $40Student — $25Beiju (over 88 years) — FreeSupporting — $300Silver — $500Gold — $1,000Platinum — $2,000 Email Address Title TitleMrMrsMsMiss First Name Initial Last Name 漢字氏名 in Kanji (if applicable) Mailing Address City State ZIP Business (if applicable) Position Business Address Business Telephone Business Email Emergency Contact's Name (in the USA) Emergency Contact's Telephone (in the USA) Emergency Contact's Address (in the USA) Emergency Contact's Name (in Japan, if applicable) Emergency Contact's Telephone (in Japan) Date of Birth Special Gift ($) Total Amount ($) JAA's Notices JAA's Notices I'd like to receive JAA's notices by email Next