Florida Country Music Association Application For Membership
NAME________________________________________________________________ ADDRESS______________________________________________________________ CITY_____________________________STATE_____________ZIP______________ AGE_________MALE_______FEMALE_______PHONE_______________________ ______________________________________________ Please circle one New Member $20.00 Renewal $16.00 (within 30 days) New Family $35.00 Renewal $25.00 (within 30 days) VOCAL______INSTRUMENT__________________________________FAN______ CHAPTER______________________________BIRTH MONTH/DAY_____/______ ______________________________________________ Sponsor____________________________________________Card #____________ CASH_______ NEW__________ CHECK______ RENEWAL_____ ______________________________________________ Applicants for Family Membership please list members: Name__________________________________BIRTH MONTH/DAY_____/______ Name__________________________________BIRTH MONTH/DAY_____/______ Name__________________________________BIRTH MONTH/DAY_____/______ |