OJMA MEMBERSHIP APPLICATION

Membership from Present Date – December 31, 2008

This form may be printed out and mailed to the address below.

Is this a renewal of a current membership? ________ or a new Member?________

Name: _____________________________ Title:_____________________________________

Organization:___________________________________________________

County: __________________________________________________

Address:_____________________________________________________________________

City, State & Zip:__________________________________________

Telephone:_________________ Fax Number:__________________

E-mail Address:___________________________________________

MEMBERSHIP DUES:
[   ] Active Member:  $50.00 
      An Active Member shall be a person and shall be entitled to one vote. 
[   ] Organizational Member:     $125.00 
      An Organizational Member shall be an organization, either a public or private entity, and shall have no vote. (Three people may be listed as members associated with an Organizational  Membership.  Each  should include a completed membership form, including contact information.)

I would like to show my support for the work of OJMA in promoting and enhancing jury service through good jury management in Ohio.  Enclosed is my tax-deductible donation to OJMA:
[   ]  $10             [   ] $20        [   ] $30        [   ] $50*
     *A $50 donation entitles you to become a non-voting, Associate Member of the Ohio Jury Management Association. 

Make checks payable to "Ohio Jury Management Association." The membership fee and the signed application should be submitted to:

     Ohio Jury Management Association
     1700 Lake Shore Drive
     Columbus, Ohio 43204

As a member of OJMA, I hereby agree to abide by the articles of incorporation, code of regulations, bylaws, and rules of this corporation.

___________________________________
Signature of Applicant  and  Date

If you have any questions, contact Vicky Unger, OJMA Director at 614-487-4475 or vunger@osbf.net .

* The Ohio Jury Management Association is a 501 (c) (3) organization. Contributions or gifts to the Ohio Jury Management Association are tax deductible as charitable contributions for income tax purposes to the fullest extent of the law.