| Fist Name: ___________
Last Name: ______________
Title: _______________ |
| Organization (if Corporate, Sponsor, Patron, or Guardian Membership): _____________________________ |
| Address: _____________________________________________________________ |
| City: __________________________
State: _____
Zip: _________ |
| Phone: ____________
Work Phone: ___________
email: __________________ |
|
___ Yes, I want to join the Marine Resources Council of East Florida ___ Yes, I want to renew my membership to the Marine Resources Council of East Florida ___ No, please take my name off the MRC Mailing list. Please list reason below: __________________________________________________________________________________ |
||
| Please check the appropriate membership category: |
__ Student ($5.00) __ General ($20.00) __ Family ($35.00) __ Supporting ($50.00) |
__ Corporate ($100.00) __ Sponsor ($250.00) __ Patron ($500.00) __ Guardian ($1000.00) |
Would you like to contribute to MRC's Endowment Fund? $__________(enclosed) | ||
| © 2003 Marine Resources Council of East Florida |