membership form

"*" indicates required fields

I am looking to

Renew my membership with CJNU

Select Membership Level (New Member)*

Select Membership Level (Renewing Member)*

Additional Contribution

As a directly listener supported radio station, every penny makes a huge difference in helping us stay on the air. If you are able to, making an additional contribution of any amount in addition to your membership fee is greatly appreciated. Thank you for your consideration.

Member Name*

First Last

Second Member Name*

First Last

Best Phone Number*

Email*

Company / Business Name*

Address*

Street Address City State / Province / Region Postal Code Country

Is it OK if we stay in touch with you?*

We may occasionally contact you to keep you up to date with what’s happening at CJNU. We will only do so if we have your permission – as per Canadian Anti-Spam Legislation.

Yes

Total

Credit Card