MEMBERSHIP APPLICATION

 

 

  FTAA Membership Application

Information provided in this application is for FTAA only
Please inform us if information listed on your application changes
Please feel free to skip those questions you prefer not to answer (all starred questions must be answered)
Please make your check payable to FTAA (please do not mail cash) and mail your check and application to:
FTAA, 3020 NE 32nd Avenue, Suite 123, Fort Lauderdale, Florida 33308 contact@ftaa.com
FTAA is a non-profit [501 (c) (3)] organization and your membership fees/donations are tax deductible!

(*) First & Last Name: ____________________________________________
(*) Mailing address: ___________________________________________

(* )Apt/Suite#:_________
(*) City: ______________________________ (*) State: _________ (*) Zip: __________
(*) Home Phone #: _______________________ (*) Fax #: _______________________
(*) Cell phone # : _________________________ (*) Work#: ______________________
(*) E-mail: _________________________________________________________________________
Occupation: ________________ Company name: _____________________________
Do you own or partner in the company you listed above (circle one):

Yes/ No/ N/A

(*) Would you work in FTAA committees/can we contact you (circle one): Yes/ No/ Undecided

(*) Spouse Name: ________________________

(*) Children’s Names/Ages: ______________________

(*) Spouse E-mail: _________________________ (*) Spouse Cell #: _____________

(*) Would your spouse work in FTAA committees/ can we contact her/him (circle one): Yes/ No/ Undecided

Do you reside in South Florida (circle one):

Year-Around                    Winter-Season                       Just-Visiting

How long have you lived in South Florida:________

How long have you been in the US?: ________

(*) Provide two FTAA member’s names as reference;
Name:_________________________________________ Tel:______________,

Name:_________________________________________ Tel:______________

(*) Have you ever been a member of an illegal organization in USA or in Turkey (circle one): Yes / No

Membership Type (circle one below)
Renewal                New member

Membership fees (circle one below)
Single (1 year): $60 Single (3 years): $125
Family (1 year): $100 Family (3 years): $250
Student (1 year): $10 Student (3 years): $25

(*) Membership fee paid: $_____, Donation: $______, Total enclosed: $_______

(*) Payment method (circle one): Cash, Check (and check # if paid with a check: _________

The information I provided on this application is true and correct.

All information I provided above is true and correct. I understand that my membership will be voided, in case of any wrongful information.

(*) Signature: ___________________________________ (*) Date: __________________

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Office use: ____________________________________________________________________________