JGSLI Change Of Address

Please print out and mail to JGSLI.

37 Westcliff Drive

Dix Hills, NY 11746

Date_____________________

Old Address (current information)

Name(s)_______________________________________________

Address________________________________________________

City____________________________State________Zip Code_____________

Phones: [day]____________________[evening]__________________

[fax] ________________ e-mail address________________________

Please fill in the CHANGED / NEW Information

Address________________________________________________

City____________________________State________Zip Code_____________

Phones: [day]____________________[evening]__________________

[fax] ________________ e-mail address________________________

OR e-mail the information to our VP Membership at membership@jgsli.org

This file last modified: 7 February 2008.
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Comments and corrections to webmaster@jgsli.org