New Member Application

Fill out this form, submit and start taking advantage of everything that being a Jaycee has to offer!
Join the York Jaycees!

Name:    Home Address:    City, State & Zip:    Email:    Home Phone:    Date of Birth:    (mo/da/year)    Employer:    How did you hear     about us?    Our annual dues are $30.00.   Payment Options:   1.   Please send your dues to :                                   York Jaycees                   P.O. Box 375                   York, NE  68467   2.   Bring your payment to the next meeting. (If your employer is going to take care of your dues, let us know.)