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New Orleans Jazz Club Membership Application
Please print this form and fax or mail
Active member: price $20.00
Fax to: (504) 779-7806
or mail with payment to:
New Orleans Jazz Club
828 Royal Street
Suite 265
New Orleans, LA 70116
Name___________________________________________
Address__________________________________________
__________________________________________
City_____________________________________________
State____________________________________________
Country__________________________________________
Zip_____________________________________________
Phone (
)______________________________________
Email____________________________________________
VISA/MC #_______________________________________
Expiration Date_____________________________________
Name on Card_____________________________________
Please contact us at jazz@nojazzclub.com
for more information |