Become a Member Form Page 2

Team Florida Membership Application

Primary Contact

Company Associates to Receive Notices & Invitations

Billing

Credit Card Billing Information

First Name:

Last Name:

Email Address:

Company Name:

Address:

City:

State:

Zip:

Credit Card Number

CVV

Authnet_Hidden_Fields

Please remit payment to:

Team Florida Marketing Partnership LLC

c/o Michelle Boylan

800 North Magnolia Avenue, Suite 1100

Orlando, FL 32803

407-956-5600

Tax ID # 47-3823394

Signature

I(WE) DO HEREBY APPLY FOR MEMBERSHIP TO TEAM FLORIDA. IN SO DOING, I(WE) AGREE TO PAY REQUIRED MEMBERSHIP FEES ANNUALLY.

I also understand that by providing my mailing address, email address, telephone number and fax number, I consent to receive communications via regular mail, email, telephone and/or fax sent by or on behalf of Team Florida and consent to this information being included in the Team Florida Membership Directory.

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