The Society of Saint John Chrysostom – Western Region
Please print and mail to the address at the bottom of the form.
Date: ___________________________________________________________________
Last Name: ______________________________________________________________
First Name: ______________________________________________________________
Sponsor (for Associate members) ___________________________________________
Type of membership: Full _____________ Associate (non-voting) ______________
Please note: Full Membership is only for members of Canonical Catholic or Orthodox jurisdictions.
Dues (payable by June 30 each year and includes national SSJC membership):
Full: $50.00/year; Associate: $40.00/year; Monastics/ Students: Please consult Treasurer.
Mailing Address:
(Light of the East, the SSJC-WR newsletter is mailed to paid members)
Street: ____________________________________________________________________
City/ State/ ZIP_____________________________________________________________
Telephone (optional unless no e-mail address)_____________________________________
E-mail (SSJC-WR notifications and communications are preferentially sent by e-mail):
___________________________________________________________________________
Your Canonical tradition/jurisdiction:
Roman Catholic ____ Eastern Catholic ____ Eastern Orthodox _____ Oriental Orthodox ___
Other ________________________________
(Associate membership only. Associate members must be sponsored by a full member.)
Your Diocese/Eparchy and name of Bishop:
_____________________________________________________________________________
Your Pastor and parish:
_____________________________________________________________________________
Talents or interests you would like to share with the Society of St. John Chrysostom:
______________________________________________________________________________
Please make your check or money order payable to: “Society of St. John Chrysostom.”
Mail to: Treasurer SSJC-WR, 2700 Katherine Street, El Cajon, CA 92020.