Canadian Association for Japanese Language Education (CAJLE)
382 Harbord Street, Toronto, Ontario M6G 1H9
Phone: 416-516-3402 or 416-422-4872   Fax: 416-422-4872

NEW MEMBERSHIP APPLICATION

I would like to apply for a CAJLE membership.
I will make the new membership fee payable to CAJLE in the amount of :

      $ 40.00 CA:  Canadian members              $ 40.00 US:  U.S. members
      $ 60.00 US:  Other country members     $ 300.00 CA:  Supporting members

The above payment will be made by:
(  ) Cash   (  ) Money Order (  ) Personal Cheque

(  ) Direct transfer into CAJLE's bank account 
Bank: CIBC
Address: 2 Bloor Street West, Toronto, Ontario M4W 2G7  Canada
Payee: Canadian Association for Japanese Language Education (CAJLE: Yoshiko Nakao)
Account No.: 491-9467
Bank Code: 00502

Last Name ( Mr.,  Mrs.,  Miss,  Ms.,  Prof.,  Dr.)____________________________

First Name__________________________Middle Name___________________

Full Name in Japanese (if any)_______________________

Street Address: 
City: 
Province: 
Postal Code: 
Country: 

Phone:  (home)________________________(work)________________________

Fax:       (home)________________________(work)_________________________

E-mail (if any)_____________________________________

Institutional Affiliation 
(relevant to Japanese language education, if any)____________________
 

Areas of interest:
(  ) Primary-Junior (Japanese as a foreign language)   (  ) High School (credit)
(  )Primary-Junior (Japanese as a heritage language)  (  ) High School (non-credit)
(  ) University    (  ) Continuing Education / Community College
(  ) Private  　 (  ) Others 
 
 

Signature___________________________Date________________________