IAJRC

Support the IAJRC

Click the Donate button to submit any amount towards the IAJRC.


Alternate Donate Method
Send a check made out to IAJRC to:

Ian Tiele
IAJRC Treasurer
3724 Morton Avenue
Brookfield, IL 60513

IAJRC Membership Profile Form

Please use the following form as a New Member to sign-up for the IAJRC or as a Current Member to update your information. New Members please visit the Dues page after filling out this form to submit your payment.

Email Address:
Name:
Mailing Address:
City:
State/Province:
Postal/Zip Code:
Country:
Home Phone:
Mobile Phone:
Has your contact information changed since the last time you updated your profile? No, everything is the same
Yes, I've made changes
Occupation:
Are you retired? Yes
No
Year Born:
Website Address:
General Collecting Interests: (check all that apply) Records, 16 RPM
Records, 33 1/3 RPM
Records, 45 RPM
Records, 78 RPM
Transcriptions
Cassettes
Reel
Tapes
Piano Rolls
Sheet Music
Cylinders
Films
Videos, VHS
Videos, DVD
Compact Disk (CD)
Books
Magazines
Other
Currently own or looking to purchase: (check all that apply) Records, 16 RPM
Records, 33 1/3 RPM
Records, 45 RPM
Records, 78 RPM
Transcriptions
Cassettes
Reel
Tapes
Piano Rolls
Sheet Music
Cylinders
Films
Videos, VHS
Videos, DVD
Compact Disk (CD)
Books
Magazines
Other
Collecting Activity: (check all that apply) Buy
Sell
Trade
Specialization:
How were you referred to us?
Nature of submitting form: New Member Signup
Current Member Updating Profile

 

IAJRC Dues

IAJRC Membership Dues Form

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Membership Email

 

Members Name:

Current Email Address:

Old Email Address*: