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Membership Application
Please fill out and Submit Application:
Name of Member: Date:
Address:
City:
State: Zip:
Telephone: Fax:
E-mail: Code:
Website:
Representative(s)*:
Business Type:
Business Description:

 

 

 

Number of characters by category: Trustee 500, Patron 400, Large Corporate 250, Small Corporate 250, Non-resident 100, Institutional 100 and Individual No Description. Please note that characters include words and spaces. The system will automatically cut any description that exceeds the maximum number of characters permitted.

Keywords:
Driving Directions:
Hours of Operation:
Credit Card:
Card Number:
Expiration Date:
Membership Category:

Trustee

 


$ 2,000/yr
*(10 repres)

Patron

 


$ 750/yr
*(5 repres)

Large Corp.

(26 or more employees)

$ 450/yr
*(3 repres)

Small Corp.

(25 or less employees)

$ 350/yr
*(3 repres)

Individual

(Non business affiliated)


$ 250/yr
*(1 repres)

Non Resident

(Companies  outside FL and Brazil)

$ 150/yr
*(1 repres)

Referred by *:

 *Must be filled out!

    

  

 

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