Membership Application — Print & Mail

Paying dues by check? Print this form, fill it out, sign it, and mail it together with your check to the JIMA office.

Application Type

New MembershipRenewal

Membership Term

One year — $150Two years — $270

Company Name *

Voting Representative *

Email Address *

Business Address *

Telephone *

Cell Phone

Fax (optional)

Website (optional)

Business Start Date

Tax ID No.

Nature / Products of Your Business *

Recommendation by a Current JIMA Member

New applications require a recommendation from one current JIMA member. If you don't know a member yet, contact the JIMA office and we will help.

Member Company

Member Contact Person

Member Telephone

Signature

Date

Mail this form with your check to:

13337 South Street, #633, Cerritos, CA 90703

Make checks payable to “JIMA International”.

Questions? Call (415) 864-5462 or email jimaintl@sbcglobal.net.